DR. SUSAN L CARLISLE (NPI# 1457361362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457361362 |
| Entity Type | Individual |
| Full Name | DR. SUSAN L CARLISLE |
| Credential | O.D. |
| Practice Address |
201 Highlands Boulevard Dr Ballwin MO 63011-4383 |
| Practice Telephone | 6362563285 |
| Mailing Telephone | 6362563285 |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2010-12-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | TO2911 | MO | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 318005006 | 05 | |
| MO | SPECTERA | 92830 | 01 |
| MO | HEALTHCARE USA | 4175 | 01 |
| DAVIS | 64485 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225042443 | Susan Carlisle | Physician Assistant | 10 Brentwood Dr, Suite B, Ithaca, NY 14850-1865 | 2006-07-27 |
| Street Address |
201 HIGHLANDS BOULEVARD DR |
| City | BALLWIN |
| State | MO |
| Zip Code | 63011-4383 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316272651 | Amy B Brunig | Optometrist | 201 Highlands Boulevard Dr, Vision Center, Ballwin, MO 63011-4383 | 2009-10-05 |
| 1114009008 | Wal-mart Stores East, Lp | Eyewear Supplier (Equipment, not the service) | 201 Highlands Boulevard Dr, Ballwin, MO 63011-4383 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205309234 | Heather Renee Leone | Nurse Practitioner | 452 Sovereign Court Suite A, Ballwin, MO 63011 | 2019-01-02 |
| 1538635297 | Jennifer Lea Nicole O'donnell | Registered Nurse | 13861 Manchester Road, Town and Country, MO 63011 | 2018-10-22 |
| 1285127712 | Genevieve Friedmann | Social Worker | 301 Sovereign Ct Ste 103, Ballwin, MO 63011 | 2018-06-09 |
| 1881187391 | Andrew Cittadino Link | Dentist | 14335 Manchester Road, Ballwin, MO 63011 | 2018-06-08 |
| 1972041283 | Anavan LLC | Durable Medical Equipment & Medical Supplies | 14390 Manchester Rd, Saint Louis, MO 63011 | 2017-02-07 |
| 1780131300 | Autism and Behavioral Spectrum LLC | Day Training, Developmentally Disabled Services | 14733 Clayton Road, Chesterfield, MO 63011 | 2016-09-01 |
| 1265872964 | Eryn Nichole Miner | Behavioral Analyst | 15834 Clayton Road, Ellisville, MO 63011 | 2013-06-27 |
| 1194168765 | Donna Margaret Carrillo | Developmental Therapist | 15834 Clayton Rd., Ellisville, MO 63011 | 2013-04-12 |
| 1891047486 | Ashley Amanda Battaglia | Chiropractor | 15945 Clayton Rd Ste 230c, Ballwin, MO 63011 | 2012-10-08 |
| 1750658480 | Gary Frank Sobocinski | Pharmacist | 4033 Sovereign Court, Ballwin, MO 63011 | 2011-11-23 |
| Find all providers in zip 63011 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548635758 | Clarkson Optometry Illinois, P.C. | Optometrist | 15933 Clayton Rd Ste 201, Ballwin, MO 63011-2172 | 2015-12-14 |
| 1023373396 | Melissa Kay Lorber | Optometrist | 821 Shady Castle Ct, Ballwin, MO 63021-4461 | 2012-07-11 |
| 1689834467 | Jay N Cohen | Optometrist | 84 Meadowbrook Country Club Est, Ballwin, MO 63011-1698 | 2008-06-14 |
| 1871643718 | Kayce A Strohmeyer | Optometrist | 15933 Clayton Rd, Suite 201, Ballwin, MO 63011-2172 | 2007-01-11 |
| 1811044506 | Cynthia Jean Lucas | Optometrist | 118 Ramsey Ln, Ballwin, MO 63021-4910 | 2007-01-04 |
| 1710045810 | Nu-crown, LLC | Optometrist | 427 Lafayette Ctr, Ballwin, MO 63011-3943 | 2006-12-04 |
| 1124031273 | Robin Leslie Meyer | Optometrist | 13901 Manchester Rd, Ballwin, MO 63011-4505 | 2006-08-13 |
| 1083668974 | Clarkson Optometry Inc | Optometrist | 14842 Manchester Rd, Ballwin, MO 63011-4620 | 2006-05-22 |
| 1497744593 | Manchester Eye Care, LLC | Optometrist | 14552 Manchester Rd, Ballwin, MO 63011-3959 | 2005-10-20 |
| 1225499098 | Clarkson Optometry Midwest Inc. | Optometrist | 15933 Clayton Rd Ste 201, Ballwin, MO 63011-2172 | 2016-03-08 |
| Find all providers in BALLWIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.