Individual provider Active NPI

Jason Bradley Bechtoldt, O.D.

  • Optometrist
  • Warrenton, MO
National Provider Identifier
1831400647
Registry record updated Jun 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2010020532 Issued in MO
Practice address
277 W Veterans Memorial Pkwy
Warrenton, MO 63383-1067
Phone
(636) 456-2020
Fax
(636) 456-3411
NPI assigned
Jun 25, 2010
Last updated
Jun 25, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2010020532 MO Primary

Addresses

Primary practice location

277 W Veterans Memorial Pkwy
Warrenton, MO 63383-1067

Mailing address

277 W Veterans Memorial Pkwy
Warrenton, MO 63383-1067
Phone (636) 456-2020

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

Practice roles

OrganizationSpecialtyStatusNew patients
Pec Warrenton LLC Optometrist Past Accepting new patients
Ernst Eye Health Associates, Inc Optometrist Past Accepting new patients

Organizations & group practices 2

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": "1277424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277424000000",
    "number": "1831400647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 W VETERANS MEMORIAL PKWY",
            "city": "WARRENTON",
            "state": "MO",
            "postal_code": "633831067",
            "telephone_number": "636-456-2020",
            "fax_number": "636-456-3411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 W VETERANS MEMORIAL PKWY",
            "city": "WARRENTON",
            "state": "MO",
            "postal_code": "633831067",
            "telephone_number": "636-456-2020",
            "fax_number": "636-456-3411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECHTOLDT",
        "first_name": "JASON",
        "middle_name": "BRADLEY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-25",
        "last_updated": "2010-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2010020532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.