Fenton Family Eyecare, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

2010020480 Issued in MO

Legal business name

FENTON FAMILY EYECARE, LLC

Practice address

1391 Smizer Mill Rd
Suite 102
Fenton, MO 63026-7306

Phone

(636) 305-9600

NPI assigned

Jan 9, 2014

Last updated

Jan 9, 2014By 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

Dr. Vito Vricella, O.D.NPI 1023241437

Title

Optometrist

Phone

(314) 406-7014

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Practitioners 2

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.

• Vito Vricella, O.D.

  • Optometrist
  • Fenton, MO
  • NPI 1023241437
  Medicare reassignment Authorized official
• Joseph Barrington Roth, OD

  • Optometrist
  • Saint Louis, MO
  • NPI 1821760422
  Medicare reassignment

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

{
    "created_epoch": "1389225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389225600000",
    "number": "1740602762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1391 SMIZER MILL RD",
            "address_2": "SUITE 102",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267306",
            "telephone_number": "636-305-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1391 SMIZER MILL RD",
            "address_2": "SUITE 102",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630267306",
            "telephone_number": "636-305-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FENTON FAMILY EYECARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-09",
        "last_updated": "2014-01-09",
        "status": "A",
        "authorized_official_last_name": "VRICELLA",
        "authorized_official_first_name": "VITO",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "314-406-7014",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2010020480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faris Al-Gebory MD LLC
• Feeling Good Home Care, LLC
• Fenton Chiropractic and Rehab Center, Inc (Spinal Care of St Louis)
• Fenton Emergency Group LLC
• Fenton Eye Care
• Fenton Family Physicians, LLC
• Fenton Family Practice, LLC
• Fenton Fire Protection District
• Fenton Pediatrics, L.L.C.
• Fenton Physical Therapy

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2014; 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.