Samuel Shelton Killion, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2022022991 Issued in MO

Practice address

915 N Grand Blvd
Saint Louis, MO 63106-1621

Phone

(314) 652-4100

NPI assigned

Jun 28, 2022

Last updated

Mar 22, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

JFJ Eyecare LTDGroup PAC ID 8224009865, 13 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.84 of 100Reported as group

Quality

92.01

Improvement activities

40

Cost

76.78

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• JFJ Eyecare, LTD

  dba Quantum Vision Centers

  • Optometrist
  • Swansea, IL
  • NPI 1376586685
  Medicare reassignment Care Compare group NPD
• JFJ Eyecare LTD

  dba Quantum Vision Centers

  • Optometrist
  • Swansea, IL
  • NPI 1295778587
  NPD
• Clarkson Optometry Illinois, P.C.

  dba Clarkson Eyecare

  • Optometrist
  • Ballwin, MO
  • NPI 1548635758
  NPD (past)
• Riverbend Ophthalmologists, LTD

  • Ophthalmology Physician
  • Godfrey, IL
  • NPI 1013994151
  NPD (past)

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

{
    "created_epoch": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1285366310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415000",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372415000",
            "telephone_number": "636-200-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 N GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631061621",
            "telephone_number": "314-652-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1272 Town and Country Crossing Dr",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "MO",
            "postal_code": "630170605",
            "country_code": "US",
            "telephone_number": "636-591-0246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12 Professional Park Dr",
            "address_purpose": "LOCATION",
            "city": "Maryville",
            "state": "IL",
            "postal_code": "620625672",
            "country_code": "US",
            "telephone_number": "618-288-7266",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4900 W Main St",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "622264725",
            "country_code": "US",
            "telephone_number": "618-235-2400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1310 Dadrian Professional Park",
            "address_purpose": "LOCATION",
            "city": "Godfrey",
            "state": "IL",
            "postal_code": "620351685",
            "country_code": "US",
            "telephone_number": "618-433-5005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3990 N Illinois St",
            "address_purpose": "LOCATION",
            "city": "Swansea",
            "state": "IL",
            "postal_code": "622261919",
            "country_code": "US",
            "telephone_number": "618-277-1130",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 W Lincoln St",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "622202019",
            "country_code": "US",
            "telephone_number": "618-234-1774",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Msc 8411",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "37241",
            "country_code": "US",
            "telephone_number": "636-200-4393",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2421 Corporate Ctr Ste 102",
            "address_purpose": "LOCATION",
            "city": "Granite City",
            "state": "IL",
            "postal_code": "620404195",
            "country_code": "US",
            "telephone_number": "618-931-6980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILLION",
        "first_name": "SAMUEL",
        "middle_name": "SHELTON",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-28",
        "last_updated": "2024-03-22",
        "certification_date": "2024-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011788",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2022022991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edward Killeen, LPC
• Katherine Ann Killeen
• Margaret Yerkes Killeen
• Amber Narcissus Killen
• Emily Killen, MD
• Moira Killoran, LPC
• Karen Kilo, RN, CDE, RD
• Candace Jo Kilpatric, PLPC
• Hannah Kilroy
• Laura Beth Kilstrom, MA

• Optometrist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2024; 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.

Verify at the official NPI Registry.