Pec St Peters LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PEC ST PETERS LLC

Practice address

6764 Mexico Rd
Saint Peters, MO 63376-1505

Phone

(618) 234-3053

NPI assigned

Dec 19, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Dirk Massie, ODNPI 1972510345

Title

Owner

Phone

(618) 234-3053

Specialties & licenses 1

Addresses

Other names 1

• Performance Eyecare Doing business as

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas Joseph Cunningham, OD

  • Optometrist
  • Chesterfield, MO
  • NPI 1053427104
  Medicare reassignment Care Compare group NPD
• John C Lyman, OD

  • Optometrist
  • Saint Peters, MO
  • NPI 1669580882
  Medicare reassignment Care Compare group NPD
• Erik Michael Peyton

  • Optometrist
  • Saint Peters, MO
  • NPI 1871118992
  Medicare reassignment Care Compare group NPD
• Dirk F Massie, OD

  • Optometrist
  • Swansea, IL
  • NPI 1972510345

  MO

  Medicare reassignment NPD Authorized official
• Susan Cerneka Dreyer, O.D.

  • Low Vision Rehabilitation Optometrist
  • Creve Coeur, MO
  • NPI 1386776714
  Medicare reassignment NPD
• Marcus Andrew Cuff, O.D

  • Optometrist
  • Swansea, IL
  • NPI 1588952501

  MO

  Medicare reassignment NPD

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513641600000",
    "number": "1669988242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 N ILLINOIS ST",
            "city": "SWANSEA",
            "state": "IL",
            "postal_code": "622267609",
            "telephone_number": "618-234-3053",
            "fax_number": "618-234-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6764 MEXICO RD",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761505",
            "telephone_number": "618-234-3053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEC ST PETERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-19",
        "last_updated": "2017-12-19",
        "status": "A",
        "authorized_official_last_name": "MASSIE",
        "authorized_official_first_name": "DIRK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-234-3053",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Performance Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sara Patterson, DMD
• Elizabeth Ann Patton
• Paul Simon DO LLC
• Jason Payton
• Pearl Imaging, LLC
• Adam Pechmann
• Danielle Peebles, D,C,
• Bria Penilton
• Brenton Pennicooke, MD
• Jill E Peper, COTA/L

• Optometrist in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; 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.