DR. GARY WAYNE DELANCEY O.D. NPI 1164413415

NPI Information

  • NPI: 1164413415
  • Provider Name: DR. GARY WAYNE DELANCEY, O.D.
  • Classification: Optometrist - 152WC0802X
  • Specialization: Corneal and Contact Management
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 113 OLD STATE RD
    SUITE 101
    ELLISVILLE, MO
    ZIP 63021
  • Phone: (636) 256-7800

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NPI Details

DR. Gary Wayne Delancey, O.D. is a corneal and contact management optometrist in Ellisville, MO. The provider is the professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea's ability to sustain successful contact lens wear, and treatment of any external eye or corneal condition which can affect contact lens wear. DR. Gary Wayne Delancey, O.D. NPI is 1164413415. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

113 OLD STATE RD
SUITE 101
ELLISVILLE, MO
ZIP 63021-042
Phone: (636) 256-7800
Fax: (636) 394-1011

The NPI 1164413415 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 11/3/2005 and was last updated on 9/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152W00000XOptometristT02255MISSOURINo
2152WC0802XOptometristCorneal and Contact ManagementT02255MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1100813OTHERBLUE CROSS
25615221OTHERAETNA
3114194OTHERCOLE
426258OTHERAVESIS
5262074OTHERNVA
6T02255OTHERVBA
7114194OTHEREYEMED
812922OTHERSPECTERA
926258OTHERBLUE CHOICE
10VP13561OTHERVCA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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