Clarkson Optometry Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

2000161247 Issued in MO

Legal business name

CLARKSON OPTOMETRY INC

Doing business as

Clarkson Eyecare

Practice address

11433 Olive Blvd
Creve Coeur, MO 63141-7108

Phone

(636) 200-4393

Fax

(314) 432-1135

NPI assigned

Nov 23, 2007

Organization subpart

No

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

Authorized official

Name

James Wachter, OD

Title

Cmo

Phone

(636) 200-4393

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Clarkson Eyecare Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Clarkson Optometry Inc

  • Optometrist
  • Saint Louis, MO
  • NPI 1790026540

  Member Of

  NPD member

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

{
    "created_epoch": "1195776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562284800000",
    "number": "1104007855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 207158",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753207158",
            "telephone_number": "636-200-4393",
            "fax_number": "636-527-0766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11433 OLIVE BLVD",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631417108",
            "telephone_number": "636-200-4393",
            "fax_number": "314-432-1135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSON OPTOMETRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-23",
        "last_updated": "2019-07-05",
        "status": "A",
        "authorized_official_last_name": "WACHTER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CMO",
        "authorized_official_telephone_number": "636-200-4393",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2000161247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "502027709",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarkson Eyecare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Clarkson Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chiropractic Care & Sports Rehab, Inc.
• Audrey Nicole Christen, BCBA
• Cassadi Christenson, LCP
• Joan Chusak, R.PH.
• Phillip Wayne Clark, DNP
• Clear Practice PLLC
• Betsy F. Clemens, M.D.
• Ethan D Cobbel
• Keara Cobbs, PMHNP
• Karen Cole, LPC

• Optometrist in Creve Coeur, MO
• Providers in Creve Coeur, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.