DR. SONIA SALAS O.D.
Complete NPI Record 1114254281
Optometrist in Saint Louis, MO
Active since November 11, 2009PECOS EnrolledAccepts Medicare Assignment
Complete NPI Dataset
This page contains the complete raw NPPES record for Dr. Sonia Salas, O.D. (NPI 1114254281), an individual optometrist provider in Saint Louis, MO. All 38 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1114254281 Field 1/38
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/38
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: SALAS Field 3/38
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: SONIA Field 4/38
- The first name of the provider, if the provider is an individual.
- Provider Name Prefix Text: DR. Field 5/38
- The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
- Provider Credential Text: O.D. Field 6/38
- The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
- Provider First Line Business Mailing Address: PO BOX 207158 Field 7/38
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: DALLAS Field 8/38
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: TX Field 9/38
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 753207158 Field 10/38
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 11/38
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 6362004393 Field 12/38
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider First Line Business Practice Location Address: 401 N EUCLID AVE Field 13/38
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: SAINT LOUIS Field 14/38
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: MO Field 15/38
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 631081601 Field 16/38
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 17/38
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 3143671848 Field 18/38
- The telephone number associated with the location address of the provider being identified.
- Provider Gender Code: F Field 21/38
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 152W00000X Field 22/38
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: 13885 Field 23/38
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: CA Field 24/38
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: N Field 25/38
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 152W00000X Field 26/38
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 2: 2012025596 Field 27/38
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 2: MO Field 28/38
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 2: Y Field 29/38
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: 12057226 Field 30/38
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 01 Field 31/38
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: MO Field 32/38
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier Issuer 1: CAQH Field 33/38
- The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
- Other Provider Identifier 2: 1114254281 Field 34/38
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 2: 05 Field 35/38
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 2: MO Field 36/38
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Is Sole Proprietor: Y Field 37/38
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
Secondary Practice Locations 13
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
169 Carondelet Plz
Location 1/13Saint Louis, MO 63105-3429 · Phone (314) 367-1848
3940 Lindell Blvd
Location 2/13Saint Louis, MO 63108-3204 · Phone (314) 516-5016 · Fax (314) 535-4741
7840 NATURAL BRIDGE, PATIENT CARE CENTER
Location 3/13ST. LOUIS, MO 63121 · Phone (314) 516-5131 · Fax (314) 516-5507
8562 - 66 Eager Rd.
Location 4/13Brentwood, MO 63144 · Phone (314) 785-7272
11941 Manchester Rd
Location 5/13Des Peres, MO 63131-4502 · Phone (314) 884-2380
917 Olive St
Location 6/13Saint Louis, MO 63101-1418 · Phone (314) 621-5303
8821 LaDue Rd
Location 7/13Saint Louis, MO 63124-2045 · Phone (314) 450-7305
3533 Dunn Rd
Location 8/13Florissant, MO 63033-6783 · Phone (314) 838-2100
230 N Lindbergh Blvd
Location 9/13Florissant, MO 63031-5904 · Phone (314) 921-9377
730 S Kirkwood Rd
Location 10/13Kirkwood, MO 63122-5929 · Phone (314) 821-2626
7335 Manchester Rd
Location 11/13Maplewood, MO 63143-3107 · Phone (314) 645-1575
9082 Overland Plz
Location 12/13Overland, MO 63114-6122 · Phone (314) 227-1132
7 N Euclid Ave
Location 13/13Saint Louis, MO 63108-1445 · Phone (314) 884-2382
Other Provider Identifiers 2
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
12057226 Other
Identifier 1/2State: MO · Issuer: Caqh
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
1114254281 Medicaid
Identifier 2/2State: MO
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
No registry entries match your active lookup criteria.
