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1400 Forum Blvd, Columbia, MO 65203-1997 | |
| (573) 446-0331 | |
| (800) 432-6004 |
| Full Name | |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 1400 Forum Blvd, Columbia, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669530887 | NPI | - | NPPES |
| 1013072966 | Other | MO | MEDICARE |
| MA1757002 | Other | MO | MEDICARE |
| 14070 | Other | MO | SPECTERA |
| 1962644732 | Other | MO | MEDICARE |
| 1669530887 | Other | MO | MEDICARE |
| MA1757 | Other | MO | MEDICARE |
| MA1757001 | Other | MO | MEDICARE |
| 1669441630 | Other | MO | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (Missouri) | Primary |
| Provider Name | Chih Jen Wang |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1861443079 PECOS PAC ID: 3375433717 Enrollment ID: I20040318000712 |
| Provider Name | Melanie Lynn Linderer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184621005 PECOS PAC ID: 5991699282 Enrollment ID: I20040712001050 |
| Provider Name | Steven Goldberg |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1871681346 PECOS PAC ID: 3971572231 Enrollment ID: I20041002000088 |
| Provider Name | Michele L Haley |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1144333675 PECOS PAC ID: 8426033531 Enrollment ID: I20041007000574 |
| Provider Name | Linda Gail Drake |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467487165 PECOS PAC ID: 9234197955 Enrollment ID: I20041230000405 |
| Provider Name | Scott Adrian Drake |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1407881105 PECOS PAC ID: 1052379773 Enrollment ID: I20041230000458 |
| Provider Name | Lisa K Groves |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1437182284 PECOS PAC ID: 6305896549 Enrollment ID: I20050126000372 |
| Provider Name | Thomas A Dettmer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1477548527 PECOS PAC ID: 8022038371 Enrollment ID: I20051201000075 |
| Provider Name | Dana J Krause |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1083639157 PECOS PAC ID: 7012911431 Enrollment ID: I20060826000014 |
| Provider Name | Jacqlyn E Long |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1992866057 PECOS PAC ID: 2365546421 Enrollment ID: I20070329000081 |
| Provider Name | Kent E Studer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770576522 PECOS PAC ID: 9335237411 Enrollment ID: I20080205000030 |
| Provider Name | Brian R Eveland |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1265449920 PECOS PAC ID: 3072410265 Enrollment ID: I20080423000060 |
| Provider Name | Stephen E Haring |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164575395 PECOS PAC ID: 2365517000 Enrollment ID: I20080822000149 |
| Provider Name | Eneida Resuli |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1598916041 PECOS PAC ID: 5799843801 Enrollment ID: I20081017000719 |
| Provider Name | Debra R Renner |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1013072966 PECOS PAC ID: 1658319249 Enrollment ID: I20081223000473 |
| Provider Name | Elizabeth Paige Hedgpath |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1669441630 PECOS PAC ID: 3971654443 Enrollment ID: I20090623000314 |
| Provider Name | Richard Craig Wilson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1538143540 PECOS PAC ID: 3870648488 Enrollment ID: I20100520000253 |
| Provider Name | Cathy Lynn Edwards |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1366627697 PECOS PAC ID: 4486784543 Enrollment ID: I20100616000352 |
| Provider Name | Charles M Lutz |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1750340741 PECOS PAC ID: 2264565225 Enrollment ID: I20100728000863 |
| Provider Name | Jill D Radkowiec |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114239092 PECOS PAC ID: 4880718956 Enrollment ID: I20100825001028 |
| Provider Name | Alexa S Kojima |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1629381769 PECOS PAC ID: 7214051366 Enrollment ID: I20100826000792 |
| Provider Name | Jeffrey A Harter |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831326339 PECOS PAC ID: 9234254319 Enrollment ID: I20100913000831 |
| Provider Name | Paul M Bernier |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1760456800 PECOS PAC ID: 3274658091 Enrollment ID: I20100917000113 |
| Provider Name | Scott Merle Burks |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1598741084 PECOS PAC ID: 6901008838 Enrollment ID: I20101102001507 |
| Provider Name | Mark D Wade |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1376512137 PECOS PAC ID: 8527043868 Enrollment ID: I20101105000548 |
| Provider Name | Douglas Herriott |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1700885860 PECOS PAC ID: 4486793072 Enrollment ID: I20120330000512 |
| Provider Name | Jeffrey Paul Enevoldsen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1558617993 PECOS PAC ID: 9739339367 Enrollment ID: I20130807000322 |
| Provider Name | Melissa Marie Enevoldsen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396092961 PECOS PAC ID: 6406005081 Enrollment ID: I20140212000756 |
| Provider Name | Christopher E Cossette |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1629483268 PECOS PAC ID: 0648496778 Enrollment ID: I20140728000527 |
| Provider Name | Jennifer L Luebbe |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184039711 PECOS PAC ID: 6608092960 Enrollment ID: I20140801001147 |
| Provider Name | Emily Pike |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1619385291 PECOS PAC ID: 5597987040 Enrollment ID: I20141118000317 |
| Provider Name | Richard M Delano |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1043692973 PECOS PAC ID: 7315256328 Enrollment ID: I20151014000615 |
| Provider Name | Rachel E Engelbarts |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1396158259 PECOS PAC ID: 6800013178 Enrollment ID: I20180228000166 |
| Provider Name | Nicholas D Zahn |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1588184386 PECOS PAC ID: 7113291154 Enrollment ID: I20180509002034 |
| Provider Name | Brad A Engelbarts |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740693431 PECOS PAC ID: 6103171145 Enrollment ID: I20180615001675 |
| Provider Name | Judy Chun |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1356419006 PECOS PAC ID: 1557433851 Enrollment ID: I20180827003552 |
| Provider Name | Julie Lafreniere |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467976373 PECOS PAC ID: 0547533598 Enrollment ID: I20181226001955 |
| Provider Name | Alicia M Genilo |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1962060293 PECOS PAC ID: 8921332297 Enrollment ID: I20190620003051 |
| Provider Name | Kyle Sherwood |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1508426503 PECOS PAC ID: 4284962606 Enrollment ID: I20190823000070 |
| Provider Name | Maggie Ellen Pohlmeier |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1275150757 PECOS PAC ID: 3678992880 Enrollment ID: I20201007000956 |
| Provider Name | Benjamin Tatsunori Iwai |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417399890 PECOS PAC ID: 8527294479 Enrollment ID: I20210324001093 |
| Provider Name | Adam P Wira |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1518527860 PECOS PAC ID: 1456788280 Enrollment ID: I20210420000084 |
| Provider Name | Theresa Wang |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1881021186 PECOS PAC ID: 2163746397 Enrollment ID: I20221007001004 |
| Provider Name | Antonio Campbell |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1912107905 PECOS PAC ID: 5698926012 Enrollment ID: I20221007001609 |
| Provider Name | Kathleen M Wilhelmus |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1134852460 PECOS PAC ID: 0547639320 Enrollment ID: I20221219000613 |
| Provider Name | Richard E Sofinski |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184847386 PECOS PAC ID: 9436333515 Enrollment ID: I20230515001236 |
| Provider Name | Stephanie D'orazio-brafman |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811372279 PECOS PAC ID: 6406156678 Enrollment ID: I20230801001243 |
| Provider Name | Jenna M Kelson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1821449174 PECOS PAC ID: 7315233517 Enrollment ID: I20230814001849 |
| Provider Name | Aaron Cheng |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1679269948 PECOS PAC ID: 4486017449 Enrollment ID: I20231025001181 |
| Provider Name | Ayhubrhan Yifru |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1427749209 PECOS PAC ID: 1557717691 Enrollment ID: I20231027002105 |
| Provider Name | Mehwish Ali |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1548736754 PECOS PAC ID: 5092169573 Enrollment ID: I20231114000247 |
| Provider Name | Todd Smith |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1831202076 PECOS PAC ID: 5597785790 Enrollment ID: I20240105002480 |
| Provider Name | Marie Bisconti |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770922692 PECOS PAC ID: 1658652540 Enrollment ID: I20240624004510 |
| Provider Name | Mary Ference |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1073734224 PECOS PAC ID: 4880580703 Enrollment ID: I20240730003641 |
| Provider Name | Amira Yamamoto |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104335801 PECOS PAC ID: 9234492364 Enrollment ID: I20240816003816 |
| Provider Name | Lauren Bozsa |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104504034 PECOS PAC ID: 9335593722 Enrollment ID: I20240923000626 |
| Provider Name | Paul Aram Jernigan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1033317417 PECOS PAC ID: 1254866957 Enrollment ID: I20241118003351 |
| Provider Name | Anna K Sadler |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1770932519 PECOS PAC ID: 6709177413 Enrollment ID: I20241209000853 |
| Provider Name | Christopher A Pena |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1518215029 PECOS PAC ID: 1850541210 Enrollment ID: I20241209002315 |
| Provider Name | Justin E Weigel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1225220346 PECOS PAC ID: 4486749736 Enrollment ID: I20241210004357 |
| Mailing Address | Practice Location Address |
|---|---|
211 E Broadway, Alton, IL 62002-6220 Ph: (618) 462-9818 | 1400 Forum Blvd, Columbia, MO 65203-1997 Ph: (573) 446-0331 |
Dr. Douglas George Biggs, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2301 W Worley St, J C Penney Optical, Columbia, MO 65203 Phone: 573-445-9750 Fax: 573-445-2917 | |
Dr. Debra R Renner, O.D. Optometrist Medicare: Medicare Enrolled Practice Location: 1400 Forum Blvd, Columbia, MO 65203 Phone: 573-446-0331 Fax: 573-446-6991 | |
Jeffrey M Gamble, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 500 Keene St, Suite 103, Columbia, MO 65201 Phone: 573-874-2030 Fax: 573-449-0253 | |
Richard Delano Iv, OD Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1 Hospital Dr, Columbia, MO 65212 Phone: 573-882-1506 Fax: 573-884-5575 | |
Jacob Bradley Moore, Optometrist Medicare: Accepting Medicare Assignments Practice Location: 500 N Keene St, Suite 103, Columbia, MO 65201 Phone: 573-874-2030 Fax: 573-449-0253 | |
Sukhvir Kaur, OD Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1205 Grindstone Pkwy Ste 113, Columbia, MO 65201 Phone: 573-442-5725 | |
Dr. Harry M Sulzberger, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 500 Keene St, Ste 103, Columbia, MO 65201 Phone: 573-874-2030 Fax: 573-449-0253 |