DE SOTO EYE CARE LLC (NPI# 1922268564) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922268564 |
| Entity Type | Organization |
| Organization Name | DE SOTO EYE CARE LLC |
| Practice Address |
126 S Main St De Soto MO 63020-2104 |
| Practice Telephone | 6365865406 |
| Practice Fax Number | 6365861969 |
| Mailing Telephone | 6365865406 |
| Mailing Fax Number | 6365861969 |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2009-07-15 |
| Authorized Official Name | DR. DOUGLAS J MC GUIRE JR. (OPTOMETRIST) |
| Authorized Official Telephone | 6365865406 |
| Authorized Official Credential | OD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | T02872 | MO | Eye and Vision Services Providers |
| Y | 152W00000X | Optometrist | T03075 | MO | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 313299505 | 05 | |
| MO | 315698803 | 05 |
| Street Address |
126 S MAIN ST |
| City | DE SOTO |
| State | MO |
| Zip Code | 63020-2104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871799106 | Gennadiy Dameshek | Optometrist | 126 S Main St, De Soto, MO 63020-2104 | 2007-06-24 |
| 1437160629 | David C Nuckols | Optometrist | 126 S Main St, De Soto, MO 63020-2104 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700435385 | Patsy Maness | Technician | 5100 Knorpp Road, De Soto, MO 63020 | 2019-09-06 |
| 1013268911 | Jane Susann Brenneke | Counselor | 116 B 2nd Street, Desoto, MO 63020 | 2012-10-02 |
| 1477634277 | Wal-mart Stores East, Lp | Technician/Technologist | 12862 State Road 21, De Soto, MO 63020 | 2006-10-18 |
| 1235109877 | John W Dickinson | Dentist | 704 N Main Street, Desoto, MO 63020 | 2006-01-25 |
| 1700883253 | Valle Ambulance District | Ambulance | 12363 State Route 21, De Soto, MO 63020 | 2005-06-30 |
| 1568893105 | Terence A. Friskel | Dentist | 110 North Main, Desoto, MO 63020 | 2013-12-09 |
| 1457541427 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 12977 State Route 21, De Soto, MO 63020-1000 | 2007-07-26 |
| 1982880084 | Thomas L. Monje, O.d. | Optometrist | 26 Jefferson Sq, De Soto, MO 63020-1031 | 2008-01-18 |
| 1548266737 | Steven Crawford | Family Medicine | 12 Jefferson Sq, De Soto, MO 63020-1031 | 2005-06-22 |
| 1720595200 | Danielle Marie Howerton | Nurse Practitioner | 12 Jefferson Sq, De Soto, MO 63020-1031 | 2018-01-05 |
| Find all providers in zip 63020 | ||||
| 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 |
|---|---|---|---|---|
| 1982880084 | Thomas L. Monje, O.d. | Optometrist | 26 Jefferson Sq, De Soto, MO 63020-1031 | 2008-01-18 |
| 1790039410 | Renee Kathleen Lane | Optometrist | 12862 State Route 21, De Soto, MO 63020-4742 | 2012-11-02 |
| 1871799106 | Gennadiy Dameshek | Optometrist | 126 S Main St, De Soto, MO 63020-2104 | 2007-06-24 |
| 1437160629 | David C Nuckols | Optometrist | 126 S Main St, De Soto, MO 63020-2104 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316553373 | Eye Surgery Consultants LLC | Optometrist | 2530 Lucy Lee Pkwy, Poplar Bluff, MO 63901-2436 | 2020-09-16 |
| 1811500069 | Pec Chesterfield, LLC | Optometrist | 317 Clarkson Rd Ste 102, Ellisville, MO 63011-2271 | 2020-08-27 |
| 1700402500 | Robert William Duncan | Optometrist | 341a N Creek Dr, Festus, MO 63028-2657 | 2020-06-18 |
| 1871118992 | Erik Michael Peyton | Optometrist | 6043 Mid Rivers Mall Dr, Saint Peters, MO 63304-1108 | 2020-06-15 |
| 1851916035 | Nicholas Portell | Optometrist | 13900 E Us Hwy, Suite A, Independence, MO 64055 | 2020-06-12 |
| 1417572686 | Caroline Mendus | Optometrist | 13900 E Us Highway 40, Independence, MO 64055-5860 | 2020-06-12 |
| 1013532464 | Novack Vision Care, LLC | Optometrist | 1166 W 103rd St, Kansas City, MO 64114-4511 | 2020-06-11 |
| 1154946564 | Kelly Erin Deering | Optometrist | 1115 N Washingston St, Chillicothe, MO 64601 | 2020-06-11 |
| 1275158859 | Krystal Rae Adams Matson | Optometrist | 608 N Maguire St, Warrensburg, MO 64093-1420 | 2020-06-10 |
| 1720601719 | Katelyn Hardy | Optometrist | 601 E Russell Ave Ste A, Warrensburg, MO 64093-9601 | 2020-05-25 |
| Find all providers with the same taxonomy | ||||
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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.