William J Odneal

Primary specialty

OptometristTaxonomy code 152W00000X

License

TO2366 Issued in MO

Practice address

466 Market St
Ste Genevieve, MO 63670-1520

Phone

(573) 883-2774

Fax

(573) 883-9087

NPI assigned

Nov 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1428451200000",
    "number": "1194804377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "466 MARKET ST",
            "city": "STE GENEVIEVE",
            "state": "MO",
            "postal_code": "636701520",
            "telephone_number": "573-883-2774",
            "fax_number": "573-883-9087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "466 MARKET ST",
            "city": "STE GENEVIEVE",
            "state": "MO",
            "postal_code": "636701520",
            "telephone_number": "573-883-2774",
            "fax_number": "573-883-9087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODNEAL",
        "first_name": "WILLIAM",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2015-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO2366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "310040316",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTOMETRY",
            "identifier": "108009",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill Suzanne Naeger, M.A., CCC-SLP
• Melissa Ann Naeger
• Solomon Noguera, M.D.
• Jordan Noland, PT, DPT
• Susan O'Donnell, MD
• Olive Branch Pediatric Specialties LLC
• Osman LLC
• Osman LLC
• Hayley Pardoe, DPT
• Pec STG LLC

• Optometrist in Ste Genevieve, MO
• Providers in Ste Genevieve, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.