DR. MORIO MIYAMOTO (NPI# 1588722748) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588722748 |
| Entity Type | Individual |
| Full Name | DR. MORIO MIYAMOTO |
| Credential | O.D. |
| Practice Address |
720 Olive St Suite 420 Saint Louis MO 63101-2338 |
| Practice Telephone | 3142310581 |
| Practice Fax Number | 3142312690 |
| Mailing Telephone | 3142310581 |
| Mailing Fax Number | 3142312690 |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2008-09-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
T2320 | MO | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | MEDICARE PTAN | 000007673 | 01 |
| MO | MEDICARE REGIOND/DMERC | 0791940001 | 01 |
| MO | 310753819 | 05 |
| Street Address |
720 OLIVE ST SUITE 420 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63101-2338 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679695118 | Joel Gary Luedeke | Dentist | 720 Olive St, Suite 1700, Saint Louis, MO 63101-2338 | 2007-04-04 |
| 1851454151 | Downtown Clinic of Optometry, Inc | Optometrist | 720 Olive St, Suite 420, Saint Louis, MO 63101-2338 | 2006-12-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992342661 | St. Louis General Hospital | Clinic/Center | 916 Olive Street, St Louis, MO 63101 | 2019-12-02 |
| 1285142711 | The Community Wellness Project | Preventive Medicine | 906 Olive Street, Suite 904, St. Louis, MO 63101 | 2018-01-18 |
| 1427591734 | David Keith Barton | Counselor | 800 North Tucker, St. Louis, MO 63101 | 2016-11-18 |
| 1477965176 | Robin Ann Kundra Md | Internal Medicine | 916 Olive Street #312, St. Louis, MO 63101 | 2014-05-29 |
| 1942494190 | Deami Faida Watson | Speech-Language Pathologist | 801 N 11th Street, Saint Louis, MO 63101 | 2007-08-30 |
| 1104049618 | Mahoney and Ballard Dmd Inc | Dentist | 720 Olive Street, Suite 1700, Saint Louis, MO 63101 | 2007-04-11 |
| 1891827259 | North County Chiropractic & Rehab, Inc | Chiropractor | 7189 Lindenbergh Blvd N, Hazlewood, MO 63101 | 2007-03-12 |
| 1063561769 | Christopher Bradley Hill | Dentist | 1113 Locust Street, St. Louis, MO 63101 | 2007-01-10 |
| 1629148903 | Perry Bartels | Dentist | 515 Olive Street Suite 1802, Saint Louis, MO 63101 | 2006-11-08 |
| 1487179859 | Jamie Mufson | Speech-Language Pathologist | 801 N 11th St, Saint Louis, MO 63101 | 2017-08-07 |
| Find all providers in zip 63101 | ||||
| Taxonomy Code | 152WC0802X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Specialization | Corneal and Contact Management |
| The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea’s ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. |
| Notes: Source: American Optometric Association [1/1/2009: added definition, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508086166 | Marlin B Neil | Optometrist | 12312 Olive Blvd Ste 150, Saint Louis, MO 63141-5468 | 2007-04-26 |
| 1295371946 | Pec South County LLC | Optometrist | 4412 Telegraph Rd, Saint Louis, MO 63129-3316 | 2019-11-18 |
| 1952725210 | Altenbernd Family Eye Care, LLC | Optometrist | 5445 Telegraph Rd, Suite 119, Saint Louis, MO 63129-3500 | 2014-02-06 |
| 1770664625 | Fontana Eyecare Associates, LLC. | Optometrist | 16 Hampton Village Plz, Suite 249, Saint Louis, MO 63109-2128 | 2006-10-18 |
| 1124037320 | Thebe Bagwasi | Optometrist | 3270 Telegraph Rd, Saint Louis, MO 63125-5565 | 2006-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114056231 | Kevin Greeley Lydon | Optometrist | 6764 Mexico Rd, Saint Peters, MO 63376-1505 | 2007-03-05 |
| 1184759284 | Ralph Melvin Butler | Optometrist | 401 Supercenter Dr, Walmart Vision Center, Jefferson City, MO 65101-8190 | 2007-02-22 |
| 1972645919 | Thomas Stanley Sandler | Optometrist | Jc Penney Optical, 4 Mid Rivers Mall Drive, St. Peters, MO 63376 | 2007-02-13 |
| 1811039910 | Rick Jon Unsell | Optometrist | 7436 Nw River Park Dr, Parkville, MO 64152-5028 | 2007-02-13 |
| 1659421303 | Ira Nathan Ettinger | Optometrist | 1701 Aroy Dr., Washington, MO 63090 | 2007-01-12 |
| 1578649547 | Lawrence Allen Aurich | Optometrist | 12420 So. 71 Highway, Grandview, MO 64030 | 2006-10-31 |
| 1093823924 | Jeffrey Donald Laferla | Optometrist | 8301 N Congress Ave, Kansas City, MO 64152-2041 | 2006-08-29 |
| 1356454060 | Frank Joseph Bier | Optometrist | 14037 Manchester Rd, Manchester, MO 63011-4513 | 2006-08-16 |
| 1548206576 | William H Gosnell | Optometrist | 17950 E 39th St S, Independence, MO 64055-3850 | 2006-06-20 |
| 1144262536 | Gerald Robert Gosnell | Optometrist | 4631 Wyandotte, Kansas City, MO 64112-1542 | 2006-06-12 |
| Find all providers with the same taxonomy | ||||
| City | SAINT LOUIS |
| Zip Code | 63101 |
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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.