Active NPI
Kevin Greeley Lydon, O.D.
- Corneal and Contact Management Optometrist
- Saint Peters, MO
National Provider Identifier
1114056231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Corneal and Contact Management Optometrist
- License
- TO 2357
- Practice address
- 6764 Mexico Rd
Saint Peters, MO 63376-1505 - Phone
- (636) 397-2020
- NPI assigned
- Mar 5, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | TO 2357 | MO | Primary |
Addresses
Primary practice location
6764 Mexico Rd
Saint Peters, MO 63376-1505
Mailing address
6764 Mexico Rd
Saint Peters, MO 63376-1505
Phone (636) 397-2020
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TO 2357 | MO | MD | Corneal and Contact Management Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eye Associates, LTD. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Ophthalmology Physician
- Saint Louis, MO
- NPI 1477677573
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250035200000",
"number": "1114056231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6764 MEXICO RD",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633761505",
"telephone_number": "636-397-2020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6764 MEXICO RD",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "633761505",
"telephone_number": "636-397-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYDON",
"first_name": "KEVIN",
"middle_name": "GREELEY",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-05",
"last_updated": "2009-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "MO",
"license": "TO 2357",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Peters, MO
- James Edward Lustig, DC
- Luxottica of America Inc. (Lenscrafters #00521)
- Luxottica Retail North America Inc (Sears Optical #C0192)
- Luxottica Retail North America Inc (Pearle Vision #6674)
- Kara Danielle Lydon, MPT
- John C Lyman, OD
- Anne Lyng Hibbard, M.D.
- Robert Daniel Lynn
- Brittany Lyons, FNP
- M&a Adkisson, LLC (Home Instead Senior Care)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.