Eye & Vision Regeneration Group, P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TO2796 Issued in MO

Legal business name

EYE & VISION REGENERATION GROUP, P.C.

Practice address

219 Chesterfield Towne Ctr
Chesterfield, MO 63005-1257

Phone

(636) 449-7400

NPI assigned

May 29, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Edward S. Jarka, O.D.

Title

President

Phone

(636) 449-7400

Specialties & licenses 2

Addresses

Other identifiers 4

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Bruce Crane II, OD

  • Optometrist
  • Union, MO
  • NPI 1144337437
  NPD (past)

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

{
    "created_epoch": "1243555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243555200000",
    "number": "1841426210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 CHESTERFIELD TOWNE CTR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051257",
            "telephone_number": "636-449-7400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 CHESTERFIELD TOWNE CTR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630051257",
            "telephone_number": "636-449-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE & VISION REGENERATION GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-29",
        "last_updated": "2009-05-29",
        "status": "A",
        "authorized_official_last_name": "JARKA",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "636-449-7400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO2796",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "11513262",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH PROVIDER ID",
            "identifier": "11839863",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "317930634",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "319058400",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2009; 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.