Jennifer S Mahurin, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2000174047 Issued in MO

Practice address

1600 Mid Rivers Mall
Saint Peters, MO 63376-4360

Phone

(636) 397-1222

Fax

(636) 278-1688

NPI assigned

Jan 11, 2007

Last updated

Apr 8, 2010By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jennifer S Kohler Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270684800000",
    "number": "1326198649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 BORGIA LN",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630317212",
            "telephone_number": "314-921-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 MID RIVERS MALL",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633764360",
            "telephone_number": "636-397-1222",
            "fax_number": "636-278-1688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHURIN",
        "first_name": "JENNIFER",
        "middle_name": "S",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2010-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2000174047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "KOHLER",
            "middle_name": "S",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; 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.