DANIEL P. ETHAKOTI (NPI# 1740662964) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740662964 |
| Entity Type | Individual |
| Full Name | DANIEL P. ETHAKOTI |
| Credential | OD |
| Practice Address |
3732 S Kingshighway Blvd Saint Louis MO 63109-1800 |
| Mailing Address |
211 E Broadway Alton IL 62002-6220 |
| Practice Telephone | 3144461134 |
| Practice Fax Number | 3144461136 |
| Mailing Telephone | 6184629818 |
| Mailing Fax Number | 8004326004 |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2015-06-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 2015020209 | MO | Eye and Vision Services Providers |
| Street Address |
3732 S KINGSHIGHWAY BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63109-1800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629121199 | Nu-crown, LLC | Optometrist | 3732 S Kingshighway Blvd, Saint Louis, MO 63109-1800 | 2007-01-19 |
| 1669648374 | Sameh Abdou Boules | Optometrist | 3732 S Kingshighway Blvd, Saint Louis, MO 63109-1800 | 2008-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013431907 | James Edward Trout | Community Health Worker | 3956 Wenzlick Ave, St Louis, MO 63109 | 2017-08-01 |
| 1750815023 | Andrea Hyde | Nurse Practitioner | 5302 Chippewa Street, Suite 301, St Louis, MO 63109 | 2017-04-13 |
| 1215362124 | Alex Sharifian Dds Francis Park Dentistry PC | Dentist | 6650 Chippewa Street, Saint Louis, MO 63109 | 2013-09-10 |
| 1881993962 | Rachel Elizabeth Hale Hasper | Counselor | 6555 Chippewa, St Louis, MO 63109 | 2011-03-15 |
| 1730369885 | Janis Marie Lampa | Physical Therapist | 5203 Chippewa, Suite 301, St. Louis, MO 63109 | 2007-11-06 |
| 1285753772 | James Matthew Jordan | Occupational Therapist | 32 Hampton Village Plaza, St Louis, MO 63109 | 2007-03-28 |
| 1730224478 | Mercy Health Services, LLC | Optometrist | 34 Hampton Village Plaza, St. Louis, MO 63109 | 2007-02-20 |
| 1801959903 | John Thomas Doyle | Dentist | 5400 Walsh St, St Louis, MO 63109 | 2006-12-19 |
| 1649339771 | Residencial Services Corporation | Assisted Living Facility | 5890 Eichelberger, St Louis, MO 63109 | 2006-12-06 |
| 1316039852 | Gary Raymond Rieser | Dentist | 3915 Watson Road, Suite 205, Saint Louis, MO 63109 | 2006-09-29 |
| Find all providers in zip 63109 | ||||
| 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 |
|---|---|---|---|---|
| 1194379115 | Zhenzhen Gao | Optometrist | 4531 Mcpherson Ave Apt 203, Saint Louis, MO 63108-1959 | 2019-07-29 |
| 1114579554 | Naba Razi Khan | Optometrist | 9924 Kennerly Rd, Saint Louis, MO 63128-2704 | 2019-07-16 |
| 1164083143 | Sara Taylor | Optometrist | 522 N New Ballas Rd Ste 113, Saint Louis, MO 63141-6820 | 2019-06-21 |
| 1891358115 | Essential Eyecare, LLC | Optometrist | 7256 Pershing Ave Unit B, Saint Louis, MO 63130-4248 | 2019-04-22 |
| 1720517386 | Morgan Rebecca Poore | Optometrist | 555 N New Ballas Rd Ste 310, Saint Louis, MO 63141-6896 | 2017-06-07 |
| 1699157735 | Katherine Gettinger | Optometrist | 28 Maryland Plz, Saint Louis, MO 63108-1526 | 2015-06-25 |
| 1083096523 | Courtney Anne Stehlin | Optometrist | 122 S County Center Way, Saint Louis, MO 63129-1092 | 2015-06-21 |
| 1861836777 | Clarkson Optometry Inc | Optometrist | 3192 S Grand Blvd, Saint Louis, MO 63118-1025 | 2013-04-22 |
| 1790026540 | Clarkson Optometry Inc | Optometrist | 5632 Telegraph Rd # A, Saint Louis, MO 63129-4243 | 2013-03-04 |
| 1538423769 | Mark Alan Wilkins | Optometrist | 5632 Telegraph Rd, Suite A, Saint Louis, MO 63129-4243 | 2012-07-03 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63109 |
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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.