Eye See Vision Center, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

EYE SEE VISION CENTER, LLC

Doing business as

Eye See Vision Center

Practice address

9549 Watson Road
Crestwood, MO 63126

Phone

(314) 651-3883

NPI assigned

Jul 24, 2023

Last updated

Jul 24, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Traci Kohm, ODNPI 1053455295

Title

Owner/Optometrist

Phone

(314) 651-3883

Specialties & licenses 1

Addresses

Other names 1

• Eye See Vision Center Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 1

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.

• Traci Lynne Kohm, O.D.

  • Optometrist
  • Saint Louis, MO
  • NPI 1053455295
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1690156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690156800000",
    "number": "1508546573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4737 E SWALLER RD",
            "city": "IMPERIAL",
            "state": "MO",
            "postal_code": "630521219",
            "telephone_number": "314-651-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9549 WATSON ROAD",
            "city": "CRESTWOOD",
            "state": "MO",
            "postal_code": "63126",
            "telephone_number": "314-651-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE SEE VISION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-24",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "KOHM",
        "authorized_official_first_name": "TRACI",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "314-651-3883",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eye See Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marion Kay McIntyre, PHD
• Mercy Pharmacy Services LLC (Mercy Pharmacy Crestwood)
• Sole Control, Inc.
• Michael E, Williams, PH.D.

• Optometrist in Crestwood, MO
• Providers in Crestwood, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.