Individual provider Active NPI

Sarah D Hubbard, OD

  • Optometrist
  • Chesterfield, MO
National Provider Identifier
1063467025
Registry record updated Oct 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2005020863 Issued in MO
Practice address
17249 Chesterfield Airport Rd
Chesterfield, MO 63005-1423
Phone
(636) 787-7000
Fax
(636) 787-0100
NPI assigned
May 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2005020863 MO Primary

Addresses

Primary practice location

17249 Chesterfield Airport Rd
Chesterfield, MO 63005-1423

Mailing address

40 E North St
Eureka, MO 63025-1205
Phone (636) 200-4393

Other identifiers 1

IdentifierTypeStateIssuer
1063467025MedicaidMO

Other names 1

  • Sarah C Davis Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060626000043 MO Practitioner - Optometry 8325050941 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2005020863MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clarkson Optometry Inc Optometrist CurrentSince Aug 20, 2014 Accepting new patients
Clarkson Optometry, Inc Optometrist CurrentSince Aug 20, 2014 Accepting new patients
Rosen Optometry Associates Inc Optometrist Past Accepting new patients
Rosen Optometry Associates Inc Optometrist Past Accepting new patients

Locations

17249 Chesterfield Airport Rd
Chesterfield, MO 63005
Phone (636) 787-0085

330 W Osage St
Pacific, MO 63069
Phone (636) 271-4500

3122 S Grand Blvd
Saint Louis, MO 63118
Phone (314) 450-7313

Interoperability endpoints

  • Direct secure messaging: sarahhubbard@direct.eyecare-partners.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412208000000",
    "number": "1063467025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 E NORTH ST",
            "city": "EUREKA",
            "state": "MO",
            "postal_code": "630251205",
            "telephone_number": "636-200-4393",
            "fax_number": "636-938-2650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17249 CHESTERFIELD AIRPORT RD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051423",
            "telephone_number": "636-787-7000",
            "fax_number": "636-787-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBBARD",
        "first_name": "SARAH",
        "middle_name": "D",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2014-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2005020863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1063467025",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "DAVIS",
            "middle_name": "C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.