Individual provider Active NPI

Coral Dundon, OD

  • Optometrist
  • Saint Louis, MO
National Provider Identifier
1447774047
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2017020396 Issued in MO
Practice address
7840 Natural Bridge Blvd
Patient Care Center
St Louis, MO 63121
Phone
(314) 516-5131
Fax
(314) 516-5507
NPI assigned
Jul 26, 2017
Last updated
May 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2017020396 MO Primary

Addresses

Primary practice location

7840 Natural Bridge Blvd
Patient Care Center
St Louis, MO 63121

Mailing address

209C Wildrose LN
Marion, IL 62959-1223
Phone (573) 778-6445

Other practice location 1

3940 Lindell Blvd
Saint Louis, MO 63108-3204
Phone (314) 516-5016

Other practice location 2

601 James R Thompson Blvd
BLDG D Ste 2030
East St Louis, IL 62201
Phone (618) 274-0169

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180627001899 MO Practitioner - Optometry 9931455367 Reassigns benefits to 2 organizations
I20180921000063 IL Practitioner - Optometry 9931455367 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Curators of the University of MissouriGroup PAC ID 6800704560, shared by 12 NPIs, 19 clinicians

Practice addresses (Care Compare)

3940 Lindell Blvd
Saint Louis, MO 63108-3204
Phone (314) 516-5016

601 James R Thompson Blvd
Suite 23030
East Saint Louis, IL 62201-1118
Phone (618) 482-8355

7840 Natural Bridge Rd
Saint Loius, MO 63121-4617
Phone (314) 516-5131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2017020396MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Curators of the University of Missouri Optometrist CurrentSince Aug 24, 2018 Accepting new patients
Curators of the University of Missouri Optometrist CurrentSince Jul 1, 2018 Accepting new patients
Curators of the University of Missouri CurrentSince Jul 1, 2018 Accepting new patients
Curators of the University of Missouri Optometrist CurrentSince Jul 1, 2018 Accepting new patients

Locations

601 James R Thompson Blvd
#2030
East Saint Louis, IL 62201

601 James R Thompson Blvd
Bldg D
East Saint Louis, IL 62201
Phone (573) 882-3629

1 University Blvd
Saint Louis, MO 63121
Phone (314) 516-5131

3940 Lindell Blvd
Saint Louis, MO 63108
Phone (314) 516-5016

7840 Natural Bridge Rd
Saint Louis, MO 63121
Phone (314) 382-6400

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1447774047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209C WILDROSE LN",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629591223",
            "telephone_number": "573-778-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7840 NATURAL BRIDGE BLVD",
            "address_2": "PATIENT CARE CENTER",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63121",
            "telephone_number": "314-516-5131",
            "fax_number": "314-516-5507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3940 Lindell Blvd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631083204",
            "country_code": "US",
            "telephone_number": "314-516-5016",
            "fax_number": "314-535-4741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 JAMES R THOMPSON BLVD",
            "address_2": "BLDG D STE 2030",
            "address_purpose": "LOCATION",
            "city": "EAST ST LOUIS",
            "state": "IL",
            "postal_code": "62201",
            "country_code": "US",
            "telephone_number": "618-274-0169",
            "fax_number": "618-274-0781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUNDON",
        "first_name": "CORAL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-07-26",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2017020396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.