Active NPI
Lisa K Foley, O.D.
- Optometrist
- Saint Louis, MO
National Provider Identifier
1609956416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2001029920
- Practice address
- 13455 Manchester Rd
Saint Louis, MO 63131-1711 - Phone
- (314) 822-4423
- Fax
- (314) 822-5541
- NPI assigned
- Oct 16, 2006
- Sex
- Female
- Sole proprietor
- No
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 | 2001029920 | MO | Primary |
Addresses
Primary practice location
13455 Manchester Rd
Saint Louis, MO 63131-1711
Mailing address
956 Forestlac CT
Saint Louis, MO 63141-6015
Phone (636) 346-9262
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 680553276 | Other | MO | S CORP TAX ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160408001612 | MO | Order and Referring Only - Optometry | 2769780667 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2001029920 | MO | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486684800000",
"number": "1609956416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "956 FORESTLAC CT",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631416015",
"telephone_number": "636-346-9262",
"fax_number": "314-822-5541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13455 MANCHESTER RD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631311711",
"telephone_number": "314-822-4423",
"fax_number": "314-822-5541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOLEY",
"first_name": "LISA",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-16",
"last_updated": "2017-02-10",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "2001029920",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "S CORP TAX ID",
"identifier": "680553276",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}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 Feb 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.