Individual provider Active NPI

Kimberly Ann Layfield, O.D.

  • Optometrist
  • Bridgeton, MO
National Provider Identifier
1407054943
Registry record updated Jul 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2007018394 Issued in MO
Practice address
12255 Depaul Drive
Suite 360
Bridgeton, MO 63044-2510
Phone
(314) 739-9293
Fax
(314) 739-3968
NPI assigned
Jul 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2007018394 MO Primary

Addresses

Primary practice location

12255 Depaul Drive
Suite 360
Bridgeton, MO 63044-2510

Mailing address

262 Valleybrook CT
O Fallon, MO 63368-9638
Phone (314) 956-7227

Other identifiers 1

IdentifierTypeStateIssuer
317423705MedicaidMO

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
I20070730000064 MO Practitioner - Optometry 0840391298 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Comprehensive Eye Care and Surgery IncGroup PAC ID 3577504471, 2 clinicians

Practice addresses (Care Compare)

12255 Depaul Dr
Suite 250
Bridgeton, MO 63044-2513
Phone (314) 739-9293

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2007018394MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Eye Care and Surgery Inc. CurrentSince Nov 1, 2011 Accepting new patients
Denise M. Harvey Dba Advanced Eyecare Optometrist PastSince Nov 24, 2024 Accepting new patients
Charles a Sigmund MD Inc Past Accepting new patients
Horizon Behavioral Health LLC Past Accepting new patients

Locations

12255 De Paul Dr
Ste 250
Bridgeton, MO 63044
Phone (314) 344-7770

12255 De Paul Dr
Ste 360
Bridgeton, MO 63044
Phone (314) 739-9293

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": "1183593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405296000000",
    "number": "1407054943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 VALLEYBROOK CT",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633689638",
            "telephone_number": "314-956-7227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12255 DEPAUL DRIVE",
            "address_2": "SUITE 360",
            "city": "BRIDGETON",
            "state": "MO",
            "postal_code": "630442510",
            "telephone_number": "314-739-9293",
            "fax_number": "314-739-3968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAYFIELD",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-05",
        "last_updated": "2014-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2007018394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "317423705",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeton, MO

Sources for this page

Verify at the official NPI Registry.