Individual provider Active NPI

David W Brigham, MD

  • Ophthalmology Physician
  • Saint Louis, MO
National Provider Identifier
1780605212
Registry record updated Sep 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
33384 Issued in MO
Practice address
12990 Manchester Rd
Suite 202
St Louis, MO 63131-1804
Phone
(314) 432-6137
Fax
(314) 432-1237
NPI assigned
Jul 21, 2006
Last updated
Sep 23, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 33384 MO Primary

Addresses

Primary practice location

12990 Manchester Rd
Suite 202
St Louis, MO 63131-1804

Mailing address

12990 Manchester Rd
Suite 202
St Louis, MO 63131-1804
Phone (314) 432-6137

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070625000077 MO Practitioner - Ophthalmology 3779517305 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
33384MOMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Eye Clinic, Inc Ophthalmology CurrentSince Jul 2, 2007 Accepting new patients

Locations

12990 Manchester Rd
Ste 20
Saint Louis, MO 63131
Phone (314) 966-5000

12990 Manchester Rd
Ste 202
Saint Louis, MO 63131
Phone (314) 432-6137

Organizations & group practices 1

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285200000000",
    "number": "1780605212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12990 MANCHESTER RD",
            "address_2": "SUITE 202",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631311804",
            "telephone_number": "314-432-6137",
            "fax_number": "314-432-1237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12990 MANCHESTER RD",
            "address_2": "SUITE 202",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "631311804",
            "telephone_number": "314-432-6137",
            "fax_number": "314-432-1237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIGHAM",
        "first_name": "DAVID",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2010-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MO",
            "license": "33384",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.