Active NPI
Tiffany J Johnson, O.D.
- Optometrist
- Saint Louis, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2005025566
- Practice address
- 9540 Manchester Rd
Saint Louis, MO 63119-1313 - Phone
- (314) 962-3830
- Fax
- (314) 962-3909
- NPI assigned
- Feb 23, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2005025566 | MO | Primary |
Addresses
Primary practice location
9540 Manchester Rd
Saint Louis, MO 63119-1313
Mailing address
40 E North St
Eureka, MO 63025-1205
Phone (636) 200-4393
Other names 1
- Dr. Tiffany J Stuckey
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Indiana University - School of Optometry, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3122 S Grand Blvd
The Spec Shoppe
St Louis, MO 63118-1012
Phone (314) 450-7313
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2005025566 | MO | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clarkson Optometry, Inc | Optometrist | Current | Accepting new patients |
| Clarkson Optometry Inc | Optometrist | Current | Accepting new patients |
| Clarkson Eyecare | Optometrist | Past | Accepting new patients |
Locations
14842 Manchester Rd
Ballwin, MO 63011
Phone (636) 557-2020
32 Four Seasons Shopping Ctr
Chesterfield, MO 63017
Phone (314) 469-3937
1729 Clarkson Rd
Chesterfield, MO 63017
Phone (636) 733-0090
17249 Chesterfield Airport Rd
Chesterfield, MO 63005
Phone (636) 787-0085
1028 Town and Country Crossing Dr
Chesterfield, MO 63017
Phone (636) 230-9190
12681 Dorsett Rd
Maryland Heights, MO 63043
Phone (314) 786-3800
9082 Overland Plz
Overland, MO 63114
Phone (314) 227-1132
330 W Osage St
Pacific, MO 63069
Phone (636) 271-4500
3122 S Grand Blvd
Saint Louis, MO 63118
Phone (314) 450-7313
9540 Manchester Rd
Saint Louis, MO 63119
Phone (314) 962-3830
6415 Chippewa St
Saint Louis, MO 63109
Phone (314) 457-1880
7335 Manchester Rd
Saint Louis, MO 63143
Phone (314) 645-1475
Interoperability endpoints
- tiffanyjohnson@direct.eyecare-partners.com
Organizations & group practices 3
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.
-
- Optometrist
- Ellisville, MO
- NPI 1497155345
-
- Optometrist
- Elk River, MN
- NPI 1952992976
-
- Optometrist
- Eureka, MO
- NPI 1205817731
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1416268800000",
"number": "1255466728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 E NORTH ST",
"city": "EUREKA",
"state": "MO",
"postal_code": "630251205",
"telephone_number": "636-200-4393",
"fax_number": "636-938-2650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9540 MANCHESTER RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631191313",
"telephone_number": "314-962-3830",
"fax_number": "314-962-3909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "TIFFANY",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-23",
"last_updated": "2014-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "2005025566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TIFFANY",
"last_name": "STUCKEY",
"middle_name": "J",
"prefix": "DR.",
"credential": "O.D.",
"code": "1",
"type": "Former 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 Nov 18, 2014; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.