Active NPI
Carol Flewellen Merritt, O.D.
- Optometrist
- Florissant, MO
National Provider Identifier
1063547735
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TO2850
- Practice address
- 45 Black Jack CT
Florissant, MO 63033-7101 - Phone
- (314) 653-2020
- Fax
- (314) 653-6299
- NPI assigned
- Feb 22, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | TO2850 | MO | Primary |
Addresses
Primary practice location
45 Black Jack CT
Florissant, MO 63033-7101
Mailing address
4401 Karen Ann CT
Florissant, MO 63034-3496
Phone (314) 831-0399
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101007000138 | MO | Practitioner - Optometry | 0143412395 | Practice locations: Florissant, MO |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of Missouri St Louis - School of Optometry, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2750 N Hwy 67
Florissant, MO 63033-1402
Phone (314) 653-2020
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TO2850 | MO | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063547735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4401 KAREN ANN CT",
"city": "FLORISSANT",
"state": "MO",
"postal_code": "630343496",
"telephone_number": "314-831-0399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "45 BLACK JACK CT",
"city": "FLORISSANT",
"state": "MO",
"postal_code": "630337101",
"telephone_number": "314-653-2020",
"fax_number": "314-653-6299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MERRITT",
"first_name": "CAROL",
"middle_name": "FLEWELLEN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "TO2850",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Florissant, MO
- Stephanie Denise Menendez, OTR
- Menm, LLC (Miracle-Ear)
- Edita B Mercado, NP
- Mercy Pharmacy Services LLC (Mercy Pharmacy Florissant)
- Tracy Lynn Meredith, R.N.
- Metro Cardiovascular, Inc. (Metro Health Center)
- Metro Dialysis Center - North, Inc. (Metro North Dialysis Center)
- Metro Medical North County LLC
- Metro Medical Urgent Care
- Metro North Eyecare David M. Picker, O.D., P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.