Courtney Anne Etzkorn, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2015019903 Issued in MO

Practice address

122 S County Center Way
Saint Louis, MO 63129-1092

Phone

(314) 416-7588

NPI assigned

Jun 21, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Luxottica of America Inc

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1434844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1083096523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 WASHINGTON TER",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631121914",
            "telephone_number": "217-725-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 S COUNTY CENTER WAY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631291092",
            "telephone_number": "314-416-7588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETZKORN",
        "first_name": "COURTNEY",
        "middle_name": "ANNE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-21",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2015019903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillian Nicole Ethridge-Brown, MSN, FNP-BC
• Madison Clare Etling, DDS
• Etoya R. White Therapy & Coaching LLC
• Charles David Ettelson, M.D.
• Oscar Etuk, D.P.M
• James Robert Etzkorn, M.D.
• Ann Louise Eubanks, PT, MHS
• Martha Eubanks, SLP
• Euclid Primary Care, P.C.
• Molly Euler, RN

• Optometrist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.