NPIMap

Organization Active NPI

Retina & Vitreous Consultants Inc

  • Ophthalmology Physician
  • Saint Louis, MO
National Provider Identifier
1255452603
Registry record updated Mar 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
RETINA & VITREOUS CONSULTANTS INC
Practice address
1034 S Brentwood Blvd
Suite 1625
Saint Louis, MO 63117-1223
Phone
(314) 881-1211
Fax
(314) 727-0705
NPI assigned
Apr 3, 2007
Last updated
Mar 13, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2012

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

Authorized official

Name
Mrs. Stacy L Deiss
Title
Credentialing Manager
Phone
(314) 367-1278

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X NU Primary

Addresses

Primary practice location

1034 S Brentwood Blvd
Suite 1625
Saint Louis, MO 63117-1223

Mailing address

1600 S Brentwood Blvd
Suite 800
Saint Louis, MO 63144-1320
Phone (314) 367-1278

Other names 1

  • RETINA & VITREOUS CONSULTANTS P.C. Other name

National Provider Directory

National Provider Directory

Locations

5 Country Club Executive Park
Glen Carbon, IL 62034
Phone (314) 567-7771

226 S Woods Mill Rd
Ste 44W
Chesterfield, MO 63017
Phone (314) 447-4995

1600 S Brentwood Blvd
Ste 800
Saint Louis, MO 63144

Practitioners & affiliated clinicians

Practitioners 41

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.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331596800000",
    "number": "1255452603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S BRENTWOOD BLVD",
            "address_2": "SUITE 800",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631441320",
            "telephone_number": "314-367-1278",
            "fax_number": "314-968-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 S BRENTWOOD BLVD",
            "address_2": "SUITE 1625",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631171223",
            "telephone_number": "314-881-1211",
            "fax_number": "314-727-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETINA & VITREOUS CONSULTANTS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2012-03-13",
        "status": "A",
        "authorized_official_last_name": "DEISS",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "314-367-1278",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "RETINA & VITREOUS CONSULTANTS P.C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Mar 13, 2012; 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.