Active NPI
Jerome Lawrence Becker, O.D.
- Optometrist
- Saint Charles, MO
National Provider Identifier
1689750291
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TO2118
- Practice address
- 1384 S 5TH St
Saint Charles, MO 63301-2444 - Phone
- (636) 946-9242
- Fax
- (636) 946-4903
- NPI assigned
- Oct 27, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- 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 | TO2118 | MO | Primary |
Addresses
Primary practice location
1384 S 5TH St
Saint Charles, MO 63301-2444
Mailing address
326 Falling Leaves CT
Creve Coeur, MO 63141-7405
Phone (314) 878-8223
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
| License | State | Type | Specialty |
|---|---|---|---|
| TO2118 | MO | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689750291",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "326 FALLING LEAVES CT",
"city": "CREVE COEUR",
"state": "MO",
"postal_code": "631417405",
"telephone_number": "314-878-8223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1384 S 5TH ST",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633012444",
"telephone_number": "636-946-9242",
"fax_number": "636-946-4903"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKER",
"first_name": "JEROME",
"middle_name": "LAWRENCE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "TO2118",
"primary": true
}
],
"identifiers": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.