Organization Active NPI

St. Louis Eye Clinic

  • Ophthalmologic Surgery Clinic/Center
  • Saint Louis, MO
National Provider Identifier
1104953660
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmologic Surgery Clinic/CenterTaxonomy code 261QS0132X
Legal business name
ST. LOUIS EYE CLINIC
Practice address
12818 Tesson Ferry Rd Ste 102&104
Saint Louis, MO 63128-2613
Phone
(314) 352-9800
Fax
(314) 352-4290
NPI assigned
Feb 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Authorized official

Name
Elizabeth Deborah Kutz
Title
Billing & Credential Manager
Phone
(314) 352-9800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmologic Surgery Clinic/Center 261QS0132X Primary

Addresses

Primary practice location

12818 Tesson Ferry Rd Ste 102&104
Saint Louis, MO 63128-2613

Mailing address

12818 Tesson Ferry Rd Ste 102&104
Saint Louis, MO 63128-2613
Phone (314) 352-9800

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749513600000",
    "number": "1104953660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12818 TESSON FERRY RD STE 102&104",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282613",
            "telephone_number": "314-352-9800",
            "fax_number": "314-352-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12818 TESSON FERRY RD STE 102&104",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282613",
            "telephone_number": "314-352-9800",
            "fax_number": "314-352-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LOUIS EYE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A",
        "authorized_official_last_name": "KUTZ",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "DEBORAH",
        "authorized_official_title_or_position": "BILLING & CREDENTIAL MANAGER",
        "authorized_official_telephone_number": "314-352-9800"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; 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.