NPIMap

Organization Active NPI

Ophthalmic Plastic & Cosmetic Surgery, Inc.

  • Specialist
  • Des Peres, MO
National Provider Identifier
1942497805
Registry record updated Sep 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MDR3N98 Issued in MO
Legal business name
OPHTHALMIC PLASTIC & COSMETIC SURGERY, INC.
Practice address
12990 Manchester Rd
Suite 102
Des Peres, MO 63131-1804
Phone
(314) 567-3567
Fax
(314) 567-6575
NPI assigned
Sep 25, 2007
Last updated
Sep 25, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2007

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

Authorized official

Name
Dr. John B Holds, M.D.NPI 1134117732
Title
Owner
Phone
(314) 567-3567

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X MDR3N98 MO Primary

Addresses

Primary practice location

12990 Manchester Rd
Suite 102
Des Peres, MO 63131-1804

Mailing address

12990 Manchester Rd
Suite 102
Des Peres, MO 63131-1804
Phone (314) 567-3567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041014000372 MO Part B Supplier - Clinic/Group Practice 5991765919 Receives reassigned benefits from 5 practitioners
Practice locations: Arnold, MO; Des Peres, MO

National Provider Directory

National Provider Directory

Locations

3530 Jeffco Blvd
Ste 100
Arnold, MO 63010
Phone (314) 567-3567

12990 Manchester Rd
Ste 102
Saint Louis, MO 63131
Phone (314) 567-3567

300 Saint Peters Centre Blvd
Ste 150
Saint Peters, MO 63376
Phone (314) 567-3567

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190678400000",
    "number": "1942497805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12990 MANCHESTER RD",
            "address_2": "SUITE 102",
            "city": "DES PERES",
            "state": "MO",
            "postal_code": "631311804",
            "telephone_number": "314-567-3567",
            "fax_number": "314-567-6575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12990 MANCHESTER RD",
            "address_2": "SUITE 102",
            "city": "DES PERES",
            "state": "MO",
            "postal_code": "631311804",
            "telephone_number": "314-567-3567",
            "fax_number": "314-567-6575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPHTHALMIC PLASTIC & COSMETIC SURGERY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2007-09-25",
        "status": "A",
        "authorized_official_last_name": "HOLDS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-567-3567",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MO",
            "license": "MDR3N98",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Peres, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.