Individual provider Active NPI

Kara C Rackovan, OD

  • Optometrist
  • Chesterfield, MO
National Provider Identifier
1831750108
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2019021875 Issued in MO
Practice address
162 THF Blvd
Chesterfield, MO 63005-1141
Phone
(636) 537-0700
NPI assigned
Jun 26, 2019
Last updated
Jul 11, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2019021875 MO Primary

Addresses

Primary practice location

162 THF Blvd
Chesterfield, MO 63005-1141

Mailing address

211 E Broadway
Alton, IL 62002-6220
Phone (618) 462-9818

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190806000695 MO Practitioner - Optometry 6406183045 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nucrown, LLCGroup PAC ID 1456256346, 22 clinicians

Practice addresses (Care Compare)

4145 Lindell Blvd
Saint Louis, MO 63108-2913
Phone (314) 533-1898

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nucrown,Inc. Optometrist CurrentSince Jul 12, 2019 Accepting new patients
Nu-Crown, LLC Optometrist CurrentSince Jul 12, 2019 Accepting new patients
Paige Hedgpath Odpc Optometrist CurrentSince Apr 3, 2025 Accepting new patients
Paige Hedgpath OD,PC Optometrist CurrentSince Apr 3, 2025 Accepting new patients
Aeg Oregon Professional LLC Optometrist Past Accepting new patients

Locations

211 E Broadway
Alton, IL 62002
Phone (314) 787-0681

162 Thf Blvd
Chesterfield, MO 63005
Phone (636) 537-0700

1400 Forum Blvd
Ste 14
Columbia, MO 65203
Phone (573) 446-0331

935 N Highway 67 St
Florissant, MO 63031
Phone (314) 838-7644

323 Monroe St
Jefferson Cty, MO 65101
Phone (573) 635-1313

1340 Big Bend Square Shop Ctr
Manchester, MO 63021
Phone (636) 225-9300

427 Lafayette Ctr
Manchester, MO 63011
Phone (636) 391-1309

4645 Osage Beach Pkwy
Ste G
Osage Beach, MO 65065
Phone (573) 635-1313

1910 1st Capitol Dr
Saint Charles, MO 63301
Phone (314) 741-8183

1012 Loughborough Ave
Saint Louis, MO 63111
Phone (314) 741-8183

11615 Olive Blvd
Saint Louis, MO 63141
Phone (314) 942-5367

3732 S Kingshighway Blvd
Saint Louis, MO 63109
Phone (314) 446-1134

4145 Lindell Blvd
Saint Louis, MO 63108
Phone (314) 533-1898

6756 Chippewa St
Saint Louis, MO 63109
Phone (314) 351-4991

8885 Ladue Rd
Saint Louis, MO 63124
Phone (314) 721-2720

9924 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 842-5858

569 Mid Rivers Mall Dr
Saint Peters, MO 63376
Phone (636) 970-2020

Organizations & group practices 5

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": "1561507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1831750108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 E BROADWAY",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620026220",
            "telephone_number": "618-462-9818",
            "fax_number": "314-741-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "162 THF BLVD",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051141",
            "telephone_number": "636-537-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACKOVAN",
        "first_name": "KARA",
        "middle_name": "C",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-26",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2019021875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

Verify at the official NPI Registry.