Individual provider Active NPI

Christopher J Brenon, O.D.

  • Optometrist
  • Leadington, MO
National Provider Identifier
1871595520
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TO3382 Issued in MO
Practice address
200 E Woodlawn Dr
Leadington, MO 63601-4436
Phone
(573) 431-1301
Fax
(573) 431-9339
NPI assigned
Aug 12, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TO3382 MO Primary

Addresses

Primary practice location

200 E Woodlawn Dr
Leadington, MO 63601-4436

Mailing address

200 E Woodlawn Dr
Leadington, MO 63601-4436
Phone (573) 431-1301

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
I20100726000876 MO Practitioner - Optometry 3870626989 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complete Vision Care IncGroup PAC ID 4981737095, 4 clinicians

Practice addresses (Care Compare)

200 E Woodlawn Dr
Leadington, MO 63601-4436
Phone (573) 431-1301

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TO3382MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Mark D Peckham OD PC 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": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1871595520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E WOODLAWN DR",
            "city": "LEADINGTON",
            "state": "MO",
            "postal_code": "636014436",
            "telephone_number": "573-431-1301",
            "fax_number": "573-431-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E WOODLAWN DR",
            "city": "LEADINGTON",
            "state": "MO",
            "postal_code": "636014436",
            "telephone_number": "573-431-1301",
            "fax_number": "573-431-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENON",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO3382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leadington, MO

Sources for this page

Verify at the official NPI Registry.