Pec Chesterfield, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

PEC CHESTERFIELD, LLC

Practice address

317 Clarkson Rd Ste 102
Ellisville, MO 63011-2271

Phone

(636) 725-2020

NPI assigned

Aug 27, 2020

Last updated

Aug 27, 2020By 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

Dirk Massie, ODNPI 1972510345

Title

Owner

Phone

(618) 234-3053

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Practitioners 3

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.

• 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
• Dirk F Massie, OD

  • Optometrist
  • Swansea, IL
  • NPI 1972510345

  MO

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1598486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598486400000",
    "number": "1811500069",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "317 CLARKSON RD STE 102",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630112271",
            "telephone_number": "636-725-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEC CHESTERFIELD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-27",
        "last_updated": "2020-08-27",
        "certification_date": "2020-08-26",
        "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_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parrish Chiropractic and Functional Health LLC
• Jason Parrish, PHARMD
• Paul Alan Parrish, DC
• Jennifer Marie Patterson, M.S.CCC/SLP
• Julie Chasen Paull, PH.D.
• Pediatric Education Dietitian Services
• Amy L Pegors, P.T.
• Catherine Jane Peterson, M.D.
• Barbara E Pine, FNP
• Jodi Glaus Pingel, PSY.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2020; 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.