NPIMap

Organization Active NPI

Nucrown, LLC

  • Optometrist
  • Saint Louis, MO
National Provider Identifier
1396135992
Registry record updated Apr 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T02999 Issued in MO
Legal business name
NUCROWN, LLC
Practice address
12607 Olive Blvd
Saint Louis, MO 63141-6313
Phone
(314) 428-0110
Fax
(314) 878-7747
NPI assigned
Feb 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2017

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

Authorized official

Name
Charles D. Matthews
Title
President
Phone
(618) 462-9818

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X T02999 MO Primary

Addresses

Primary practice location

12607 Olive Blvd
Saint Louis, MO 63141-6313

Mailing address

211 E Broadway
Alton, IL 62002-6220
Phone (618) 462-9818

Other names 1

  • Crown Optical Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Crown Optical3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1422921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492732800000",
    "number": "1396135992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E BROADWAY",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026220",
            "telephone_number": "618-462-9818",
            "fax_number": "800-432-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12607 OLIVE BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631416313",
            "telephone_number": "314-428-0110",
            "fax_number": "314-878-7747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUCROWN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-03",
        "last_updated": "2017-04-21",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-462-9818"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crown Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 21, 2017; 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.