Organization Active NPI

Gelner Optometry, P.C.

  • Optometrist
  • Chesterfield, MO
National Provider Identifier
1093032773
Registry record updated Apr 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
GELNER OPTOMETRY, P.C.
Practice address
14386 Woodlake Dr
Chesterfield, MO 63017-5714
Phone
(314) 434-2626
Fax
(314) 434-2631
NPI assigned
Apr 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2010

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

Authorized official

Name
Dr. Patricia Virtue Gelner, O.D.NPI 1396794053
Title
President
Phone
(314) 434-2626

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

14386 Woodlake Dr
Chesterfield, MO 63017-5714

Mailing address

14386 Woodlake Dr
Chesterfield, MO 63017-5714
Phone (314) 434-2626

Other identifiers 6

IdentifierTypeStateIssuer
32331OtherMOBLUE CROSS
07144OtherMOSPECTERA
256594214OtherMOMEDICARE ID - TYPE UNSPECIFIED
325596OtherMOHEALTHLINK
MO2393OtherMOEYEMED
GE312309800MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040724000221 MO Part B Supplier - Clinic/Group Practice 1254311673 Receives reassigned benefits from 1 practitioner
Practice locations: Chesterfield, MO

National Provider Directory

National Provider Directory

Locations

14386 Woodlake Dr
Chesterfield, MO 63017
Phone (314) 434-2626

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271808000000",
    "number": "1093032773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14386 WOODLAKE DR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175714",
            "telephone_number": "314-434-2626",
            "fax_number": "314-434-2631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14386 WOODLAKE DR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175714",
            "telephone_number": "314-434-2626",
            "fax_number": "314-434-2631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GELNER OPTOMETRY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-21",
        "last_updated": "2010-04-21",
        "status": "A",
        "authorized_official_last_name": "GELNER",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "VIRTUE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "314-434-2626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "32331",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECTERA",
            "identifier": "07144",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID - TYPE UNSPECIFIED",
            "identifier": "256594214",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "325596",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "MO2393",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GE312309800",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.