Sarah Nicole Gore, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2013017927 Issued in MO

Practice address

310 W. Losey St
Optometry
Scott Air Force Base, IL 62225

Phone

(618) 256-2392

Fax

(314) 362-3564

NPI assigned

Nov 5, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1013957562
  Medicare reassignment NPD
• Clarkson Optometry, Inc

  • Optometrist
  • Ellisville, MO
  • NPI 1497155345
  Medicare reassignment
• Washington University

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1962442475
  NPD

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

{
    "created_epoch": "1383609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1871922369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 W. LOSEY ST",
            "address_2": "OPTOMETRY",
            "city": "SCOTT AIR FORCE BASE",
            "state": "IL",
            "postal_code": "62225",
            "telephone_number": "618-256-2392",
            "fax_number": "314-362-3564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W. LOSEY ST",
            "address_2": "OPTOMETRY",
            "city": "SCOTT AIR FORCE BASE",
            "state": "IL",
            "postal_code": "62225",
            "telephone_number": "618-256-2392",
            "fax_number": "314-362-3564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GORE",
        "first_name": "SARAH",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-05",
        "last_updated": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2013017927",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "310012306",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "450 N New Ballas Rd",
            "address_2": "Dept Ophthalmology, Ste 260",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631416859",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sheila Bonnie Durlester, PNP
• Cheryl Lynn Frietch, R.D.
• Leeann Jeanette Funk, LCSW
• Michelle Kay Garris, CCC-SLP
• Joseph William Glovacz Jr., PHARM.D.
• Jennifer Renee Hardin, CNS
• Jeffrey Roger Herchler, APA-C
• Terese (Terri) Ann Hoef, RDH
• Robie Victoria Hughes, NURSE
• Sylvia N Iyaya, NP

• Optometrist in Scott Air Force Base, IL
• Providers in Scott Air Force Base, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.