Surevision Eye Centers Midwest LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

SUREVISION EYE CENTERS MIDWEST LLC

Practice address

320 Brookes Dr Ste 111
Hazelwood, MO 63042-2735

Phone

(314) 726-5669

Fax

(314) 726-5109

NPI assigned

May 15, 2009

Organization subpart

No

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

Authorized official

Name

Shelley Lynn Miana, COE

Title

Coo

Phone

(314) 726-5669

Specialties & licenses 2

Addresses

Locations

Practitioners 5

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

• Tonya K Bourn, O.D.

  • Optometrist
  • Creve Coeur, MO
  • NPI 1851340152
  NPD
• Matthew K McCoy, OD

  • Optometrist
  • Saint Peters, MO
  • NPI 1043835580
  NPD
• Jessica L. Weis, OD

  • Corneal and Contact Management Optometrist
  • O Fallon, IL
  • NPI 1205406766
  NPD
• Jarod Lance McCullough, O.D.

  • Optometrist
  • Festus, MO
  • NPI 1841323300
  NPD (past)
• Sean P Mulqueeny, OD

  • Optometrist
  • Creve Coeur, MO
  • NPI 1407871296
  NPD (past)

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

{
    "created_epoch": "1242345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694995200000",
    "number": "1982839262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 BROOKES DR",
            "address_2": "STE 111",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630422736",
            "telephone_number": "314-726-5669",
            "fax_number": "314-726-5109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 BROOKES DR STE 111",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630422735",
            "telephone_number": "314-726-5669",
            "fax_number": "314-726-5109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUREVISION EYE CENTERS MIDWEST LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-15",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A",
        "authorized_official_last_name": "MIANA",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "314-726-5669",
        "authorized_official_credential": "COE"
    },
    "taxonomies": [
        {
            "code": "261QS0132X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ophthalmologic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Stone
• Tomma Chevon Stowers, AGNP
• Gordon Edgar Stuart, DDS
• Sunshine Adult Day Care Facility
• Surety Healthcare Services, LLC
• Nancy Mah Suvansri
• Michelle Marie Sykes, MS. CCC-SLP
• Alyssa Taylor, DPT
• Corita Taylor
• Morgan D Taylor, ATC, LAT

• Durable Medical Equipment & Medical Supplies in Hazelwood, MO
• Providers in Hazelwood, MO by specialty
• Durable Medical Equipment & Medical Supplies in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.