Individual provider Active NPI

Theresa T Nguyen, O.D.

  • Optometrist
  • Saint Louis, MO
National Provider Identifier
1649406067
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2010005351 Issued in MO
Practice address
1 Jefferson Barracks Dr
Saint Louis, MO 63125-4181
Phone
(314) 652-4100
Fax
(314) 894-5775
NPI assigned
Jun 1, 2009
Last updated
Dec 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2617 OK
Optometrist 152W00000X 2010005351 MO Primary

Addresses

Primary practice location

1 Jefferson Barracks Dr
Saint Louis, MO 63125-4181

Mailing address

1 Jefferson Barracks Dr
Saint Louis, MO 63125-4181
Phone (314) 652-4100

Other practice location 1

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

Other practice location 2

7840 Natural Bridge Blvd Patient Care Center
St Louis, MO 63121
Phone (314) 516-5131

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191220000959 MO Practitioner - Optometry 9436296530 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Curators of the University of Missouri Optometrist CurrentSince Nov 9, 2019 Accepting new patients
Curators of the University of Missouri CurrentSince Nov 9, 2019 Accepting new patients
Curators of the University of Missouri Optometrist CurrentSince Nov 9, 2019 Accepting new patients
Cherokee Nation Past Accepting new patients
Cherokee Nation PastSince Mar 1, 2021 Accepting new patients
Northeastern State University College of Optometry Optometrist PastSince Jul 1, 2025 Accepting new patients

Locations

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

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/2d405cde-1d8b-4a50-adff-ca7776cd856e/

Organizations & group practices 6

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": "1243814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1649406067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JEFFERSON BARRACKS DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631254181",
            "telephone_number": "314-652-4100",
            "fax_number": "314-894-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JEFFERSON BARRACKS DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631254181",
            "telephone_number": "314-652-4100",
            "fax_number": "314-894-5775"
        }
    ],
    "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": "7840 NATURAL BRIDGE BLVD PATIENT CARE CENTER",
            "address_purpose": "LOCATION",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63121",
            "country_code": "US",
            "telephone_number": "314-516-5131",
            "fax_number": "314-516-5507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "THERESA",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-06-01",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "2617",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2010005351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.