Active NPI
Thomas Errol Kraemer, OD
- Optometrist
- Belleville, IL
National Provider Identifier
1487643540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046 006468
- Practice address
- 3540 N Belt W
Ste C
Belleville, IL 62226-5975 - Phone
- (618) 235-4433
- Fax
- (618) 235-7483
- NPI assigned
- Oct 20, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046 006468 | IL | Primary |
Addresses
Primary practice location
3540 N Belt W
Ste C
Belleville, IL 62226-5975
Mailing address
3540 N Belt W
Ste C
Belleville, IL 62226-5975
Phone (618) 235-4433
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2203038 | Other | UNITED HEALTH CARE | |
| 8282033 | Other | IL | BLUE CROSS BLUE SHIELD |
| 239335 | Other | HEALTHLINK | |
| 400701 | Other | GHP ADVANTRA | |
| 5245266 | Other | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046 006468 | IL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265673600000",
"number": "1487643540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3540 N BELT W",
"address_2": "STE C",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622265975",
"telephone_number": "618-235-4433",
"fax_number": "618-235-7483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3540 N BELT W",
"address_2": "STE C",
"city": "BELLEVILLE",
"state": "IL",
"postal_code": "622265975",
"telephone_number": "618-235-4433",
"fax_number": "618-235-7483"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRAEMER",
"first_name": "THOMAS",
"middle_name": "ERROL",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-20",
"last_updated": "2010-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046 006468",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "2203038",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "8282033",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHLINK",
"identifier": "239335",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHP ADVANTRA",
"identifier": "400701",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "5245266",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Belleville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.