Individual provider Active NPI

Cathy Lynn Edwards, O.D.

  • Optometrist
  • Saint Louis, MO
National Provider Identifier
1366627697
Registry record updated Jan 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T02908 Issued in MO
Practice address
621 S New Ballas Rd Ste 140a
Saint Louis, MO 63141-8254
Phone
(314) 251-6430
NPI assigned
Jan 6, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T02908 MO Primary

Addresses

Primary practice location

621 S New Ballas Rd Ste 140a
Saint Louis, MO 63141-8254

Mailing address

621 S New Ballas Rd Ste 140a
Saint Louis, MO 63141-8254
Phone (314) 251-6430

Other practice location 1

851 E 5th St Ste 112
Washington, MO 63090-3128
Phone (636) 239-8345

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100616000352 MO Practitioner - Optometry 4486784543 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Paige Hedgpath OD,PC Optometrist CurrentSince Apr 22, 2024 Accepting new patients
Dang Eyecare & Associates, P.a. Optometrist CurrentSince Feb 16, 2021 Accepting new patients
Paige Hedgpath Odpc Optometrist CurrentSince Apr 22, 2024 Accepting new patients
Susan J. Devine OD, LLC Optometrist Past Accepting new patients

Locations

745 E Joyce Blvd
Ste 124
Fayetteville, AR 72703
Phone (479) 582-1366

4189 Phoenix Ave
Ste B
Fort Smith, AR 72903
Phone (479) 434-4668

1400 Forum Blvd
Ste 14
Columbia, MO 65203
Phone (573) 446-0331

138 S Main St
Gravois Mills, MO 65037
Phone (573) 280-2884

323 Monroe St
Jefferson Cty, MO 65101
Phone (573) 635-1313

4645 Osage Beach Pkwy
Ste G
Osage Beach, MO 65065
Phone (573) 635-1313

6756 Chippewa St
Saint Louis, MO 63109
Phone (314) 351-4991

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1199577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1366627697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 140A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418254",
            "telephone_number": "314-251-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 S NEW BALLAS RD STE 140A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418254",
            "telephone_number": "314-251-6430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "851 E 5th St Ste 112",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "MO",
            "postal_code": "630903128",
            "country_code": "US",
            "telephone_number": "636-239-8345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "CATHY",
        "middle_name": "LYNN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-06",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.