NPIMap

Organization Active NPI

Paige Hedgpath OD,PC

  • Optometrist
  • Jefferson City, MO
National Provider Identifier
1962644732
Registry record updated Aug 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TO3287 Issued in MO
Legal business name
PAIGE HEDGPATH OD,PC
Practice address
1709 Missouri Boulevard
Units Ijk
Jefferson City, MO 65101-3105
Phone
(573) 635-1313
Fax
(573) 634-8500
NPI assigned
Mar 25, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2024

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

Authorized official

Name
Dr. Elizabeth Paige Hedgpath, ODNPI 1669441630
Title
President
Phone
(573) 635-1313

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
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X TO3287 MO Primary

Addresses

Primary practice location

1709 Missouri Boulevard
Units Ijk
Jefferson City, MO 65101-3105

Mailing address

323 Monroe St
Jefferson City, MO 65101-3105
Phone (573) 635-1313

Other identifiers 10

IdentifierTypeStateIssuer
1669441630OtherMOMEDICARE
MA1757OtherMOMEDICARE
1013072966OtherMOMEDICARE
410048085OtherRAILROAD MEDICARE
MA1757002OtherMOMEDICARE
1962644732OtherMOMEDICARE
1376601484OtherMOMEDICARE
1669530887OtherMOMEDICARE
1962644732OtherMOGROUP NPI
MA1757001OtherMOMEDICARE

Other names 1

  • Eyes On Missouri Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090623000274 MO Part B Supplier - Clinic/Group Practice 5991856460 Receives reassigned benefits from 81 practitioners
1 other NPI on this enrollment
Practice locations: Saint Louis, MO; Raytown, MO; Raymore, MO; Osage Beach, MO; Manchester, MO; Lees Summit, MO; Jefferson City, MO; Gravois Mills, MO…

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

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

1709 Missouri Blvd
Jefferson City, MO 65109
Phone (573) 635-1313

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

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

Practitioners & affiliated clinicians

Practitioners 82

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

View all 82

NPI Registry JSON

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

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1962644732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 MONROE ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651013105",
            "telephone_number": "573-635-1313",
            "fax_number": "573-634-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 MISSOURI BOULEVARD",
            "address_2": "UNITS IJK",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651013105",
            "telephone_number": "573-635-1313",
            "fax_number": "573-634-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIGE HEDGPATH OD,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-25",
        "last_updated": "2024-08-13",
        "certification_date": "2024-08-06",
        "status": "A",
        "authorized_official_last_name": "HEDGPATH",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "PAIGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-635-1313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO3287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1669441630",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "MA1757",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1013072966",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410048085",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "MA1757002",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1962644732",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1376601484",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "1669530887",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1962644732",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "MA1757001",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyes On Missouri",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.