Basic Information
| Provider Information | |||||||||
| NPI: | 1871643718 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STROHMEYER | ||||||||
| FirstName: | KAYCE | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 352 S BROADVIEW ST | ||||||||
| Address2: | |||||||||
| City: | CAPE GIRARDEAU | ||||||||
| State: | MO | ||||||||
| PostalCode: | 637035703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5733348595 | ||||||||
| FaxNumber: | 5733344143 | ||||||||
| Practice Location | |||||||||
| Address1: | 15933 CLAYTON RD | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | BALLWIN | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630112172 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6362004393 | ||||||||
| FaxNumber: | 6365270766 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/11/2007 | ||||||||
| LastUpdateDate: | 03/22/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 2003026559 | MO | Y | Eye and Vision Services Providers | Optometrist | 152WP0200X | 2003026559 | MO | N | Eye and Vision Services Providers | Optometrist | Pediatrics | 152WV0400X | 2003206559 | MO | N | Eye and Vision Services Providers | Optometrist | Vision Therapy |
ID Information
| ID | Type | State | Issuer | Description | 183821 | 01 | MO | BLUE SHIELD PROVIDER # | OTHER | 319301628 | 05 | MO | MEDICAID |