Nucrown, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

TO2999 Issued in MO

Legal business name

NUCROWN, LLC

Doing business as

Crown Optical

Practice address

1817 Maplewood Commons Dr
Maplewood, MO 63143-1000

Phone

(314) 296-5367

Fax

(314) 296-5135

NPI assigned

Mar 13, 2012

Last updated

Apr 21, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles D. Matthews

Title

President

Phone

(618) 462-9818

Specialties & licenses 1

Addresses

Other names 1

• Crown Optical Doing business as

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492732800000",
    "number": "1245505098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E BROADWAY",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026220",
            "telephone_number": "800-407-2696",
            "fax_number": "314-741-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1817 MAPLEWOOD COMMONS DR",
            "city": "MAPLEWOOD",
            "state": "MO",
            "postal_code": "631431000",
            "telephone_number": "314-296-5367",
            "fax_number": "314-296-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUCROWN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-13",
        "last_updated": "2017-04-21",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-462-9818"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO2999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crown Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Maplewood, MO
• Providers in Maplewood, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; 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.