Charles William Pelton, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2012017231 Issued in MO

Practice address

126 S Main St
De Soto, MO 63020-2104

Phone

(636) 586-5406

Fax

(636) 586-1969

NPI assigned

Jul 9, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Desoto Vision Care LLC

  • Eyewear Supplier
  • De Soto, MO
  • NPI 1356161509

  MO, Optometrist

  Medicare reassignment NPD Authorized official
• De Soto Eye Care LLC

  • Optometrist
  • De Soto, MO
  • NPI 1922268564
  NPD
• West County Eye Care LLC

  • Optometrist
  • Manchester, MO
  • NPI 1932417870
  NPD

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758499200000",
    "number": "1962767665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 S MAIN ST",
            "city": "DE SOTO",
            "state": "MO",
            "postal_code": "630202104",
            "telephone_number": "636-586-5406",
            "fax_number": "636-586-1969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 S MAIN ST",
            "city": "DE SOTO",
            "state": "MO",
            "postal_code": "630202104",
            "telephone_number": "636-586-5406",
            "fax_number": "636-586-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELTON",
        "first_name": "CHARLES",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-09",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2012017231",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• My Place Too, Inc
• Caly Otec
• Theresa Angela Palmer, L.P.C.
• Parity Foundation Inc.
• Robin J. Patton
• Tessa Marie Penick
• Sundra Pinson
• Primary Care de Soto, LLC
• Megan Brooke Reando, FNP-C
• Zsophia C Reed

• All providers in De Soto, MO
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.