NPIMap

Organization Active NPI

The Retina Institute LLC

Doing business as Barnes Retina Institute

  • Ophthalmology Physician
  • Saint Louis, MO
National Provider Identifier
1407858673
Registry record updated Jan 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
N/A Issued in MO
Legal business name
THE RETINA INSTITUTE LLC
Doing business as
Barnes Retina Institute
Practice address
4921 Parkview PL
Ste 12B
Saint Louis, MO 63110-1032
Phone
(314) 367-1181
Fax
(314) 968-5117
NPI assigned
Jun 1, 2005
Last updated
Jan 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2009

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

Authorized official

Name
Dr. M Gilbert Grand, M.D.
Title
Manager
Phone
(314) 367-1181

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X N/A MO Primary

Addresses

Primary practice location

4921 Parkview PL
Ste 12B
Saint Louis, MO 63110-1032

Mailing address

1600 S Brentwood Blvd
Ste 800
Saint Louis, MO 63144-1317
Phone (314) 367-1181

Other identifiers 3

IdentifierTypeStateIssuer
541OtherMOBCBS
502111305MedicaidMO
04121950OtherILBCBS

Other names 1

  • BARNES RETINA INSTITUTE Doing business as

National Provider Directory

National Provider Directory

Locations

3 Professional Dr
Alton, IL 62002
Phone (618) 465-2020

215 Dunn Rd
Florissant, MO 63031
Phone (314) 315-9911

12348 Old Tesson Rd
Ste 280
Saint Louis, MO 63128

Practitioners & affiliated clinicians

Practitioners 75

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 75

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232668800000",
    "number": "1407858673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 S BRENTWOOD BLVD",
            "address_2": "STE 800",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631441317",
            "telephone_number": "314-367-1181",
            "fax_number": "314-968-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 PARKVIEW PL",
            "address_2": "STE 12B",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101032",
            "telephone_number": "314-367-1181",
            "fax_number": "314-968-5117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE RETINA INSTITUTE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-01",
        "last_updated": "2009-01-23",
        "status": "A",
        "authorized_official_last_name": "GRAND",
        "authorized_official_first_name": "M  GILBERT",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "314-367-1181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "N/A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "541",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "502111305",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "04121950",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BARNES RETINA INSTITUTE",
            "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 Jan 23, 2009; 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.