Active NPI
Clarkson Optometry Inc
- Optometrist
- Eureka, MO
National Provider Identifier
1326090267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- CLARKSON OPTOMETRY INC
- Practice address
- 40 E North St
Eureka, MO 63025 - Phone
- (636) 200-4393
- Fax
- (636) 938-2650
- NPI assigned
- May 17, 2006
- Last updated
- Jul 5, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jessica Holt
- Title
- Manager of Central Operations
- Phone
- (636) 200-4393
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | NU | Primary |
Addresses
Primary practice location
40 E North St
Eureka, MO 63025
Mailing address
PO Box 207158
Dallas, TX 75320-7158
Phone (636) 200-4393
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 502027709 | Medicaid | MO | |
| CE9167 | Other | MO | RAILROAD MEDICARE |
National Provider Directory
National Provider Directory- Tax ID family
- Clarkson Optometry Inc
Other organizations with this tax ID 43
Organizations that report the same tax identification number in the National Provider Directory.
Locations
6663 Edwardsville Crossing Dr
#B
Edwardsville, IL 62025
Phone (618) 659-2320
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1562284800000",
"number": "1326090267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 207158",
"city": "DALLAS",
"state": "TX",
"postal_code": "753207158",
"telephone_number": "636-200-4393",
"fax_number": "636-527-0766"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 E NORTH ST",
"city": "EUREKA",
"state": "MO",
"postal_code": "63025",
"telephone_number": "636-200-4393",
"fax_number": "636-938-2650"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CLARKSON OPTOMETRY INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-17",
"last_updated": "2019-07-05",
"status": "A",
"authorized_official_last_name": "HOLT",
"authorized_official_first_name": "JESSICA",
"authorized_official_title_or_position": "MANAGER OF CENTRAL OPERATIONS",
"authorized_official_telephone_number": "636-200-4393"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "502027709",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CE9167",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eureka, MO
- Chiropro of Eureka, LLC
- Vincent Michael Cifarelli, MSW LCSW ACSW DCSW
- Hawa Cissokho, PMHNP
- Clarkson Eyecare
- Clarkson Eyecare Inc
- Clarkson Optometry Inc (Clarkson Eyecare)
- Clarkson Optometry Inc (Clarkson Eyecare)
- Clarkson Optometry Midwest Inc. (Thoma and Sutton)
- Carly Jean Clonts
- Hailey Nicole Coffindaffer, PT, DPT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.