Individual provider Active NPI

Barbara Willis Brown, O.D.

  • Optometrist
  • Saint Charles, MO
National Provider Identifier
1497966923
Registry record updated Jan 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
T02948 Issued in MO
Practice address
1592 Country Club Plaza Dr
Saint Charles, MO 63303-3859
Phone
(636) 949-2900
Fax
(636) 949-2270
NPI assigned
May 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T02948 MO Primary

Addresses

Primary practice location

1592 Country Club Plaza Dr
Saint Charles, MO 63303-3859

Mailing address

2533 Woodson Rd
Saint Louis, MO 63114-5436
Phone (314) 423-3874

Other identifiers 2

IdentifierTypeStateIssuer
11769916OtherMOCAQH
TO2948OtherMOMISSOURI LICENSE

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

LicenseStateTypeSpecialty
T02948MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Overland Optical, Inc. Past Accepting new patients
Rosen Optometry Associates Inc Optometrist Past Accepting new patients
Overland Optical, Inc Past Accepting new patients
Rosen Optometry Associates Inc Optometrist Past Accepting new patients

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": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294876800000",
    "number": "1497966923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2533 WOODSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631145436",
            "telephone_number": "314-423-3874",
            "fax_number": "888-423-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1592 COUNTRY CLUB PLAZA DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633033859",
            "telephone_number": "636-949-2900",
            "fax_number": "636-949-2270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "BARBARA",
        "middle_name": "WILLIS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2011-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11769916",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI LICENSE",
            "identifier": "TO2948",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; 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.