Active NPI
Cynthia Jean Lucas, O.D.
- Optometrist
- Ballwin, MO
National Provider Identifier
1811044506
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- TO-3419
- Practice address
- 118 Ramsey LN
Ballwin, MO 63021-4910 - Phone
- (636) 227-5524
- Fax
- (636) 227-9134
- NPI assigned
- Jan 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | TO-3419 | MO | Primary |
Addresses
Primary practice location
118 Ramsey LN
Ballwin, MO 63021-4910
Mailing address
118 Ramsey LN
Ballwin, MO 63021-4910
Phone (636) 227-5524
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 16639 | Other | MO | BUREAU OF NARCOTICS # |
| TO-3419 | Other | MO | STATE LICENSE |
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 |
|---|---|---|---|
| TO-3419 | MO | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1811044506",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "118 RAMSEY LN",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630214910",
"telephone_number": "636-227-5524",
"fax_number": "636-227-9134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "118 RAMSEY LN",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630214910",
"telephone_number": "636-227-5524",
"fax_number": "636-227-9134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCAS",
"first_name": "CYNTHIA",
"middle_name": "JEAN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "TO-3419",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BUREAU OF NARCOTICS #",
"identifier": "16639",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "TO-3419",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ballwin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.