Organization Active NPI

Berry Optometry LLC

  • Optometrist
  • Cape Girardeau, MO
National Provider Identifier
1114359106
Registry record updated Aug 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2012025572 Issued in MO
Legal business name
BERRY OPTOMETRY LLC
Practice address
263 W Park Mall
Cape Girardeau, MO 63703-6341
Phone
(573) 332-0110
NPI assigned
Aug 1, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2013

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

Authorized official

Name
Dr. Morgan Berry, OD
Title
Optometrist
Phone
(618) 926-3020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 2012025572 MO Primary

Addresses

Primary practice location

263 W Park Mall
Cape Girardeau, MO 63703-6341

Mailing address

1818 Ricardo Dr
Cape Girardeau, MO 63701-3838
Phone (618) 926-3020

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375315200000",
    "number": "1114359106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1818 RICARDO DR",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637013838",
            "telephone_number": "618-926-3020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 W PARK MALL",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036341",
            "telephone_number": "573-332-0110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERRY OPTOMETRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-01",
        "last_updated": "2013-08-01",
        "status": "A",
        "authorized_official_last_name": "BERRY",
        "authorized_official_first_name": "MORGAN",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "618-926-3020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2012025572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.