NPIMap

Organization Active NPI

David Wichnoksi OD PA

  • Optometrist
  • Charlotte, NC
National Provider Identifier
1013253418
Registry record updated Dec 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1632 Issued in NC
Legal business name
DAVID WICHNOKSI OD PA
Practice address
200 S College St Ste 307
Charlotte, NC 28202-2065
Phone
(704) 334-4444
Fax
(704) 334-4441
NPI assigned
Dec 13, 2012
Organization subpart
Yes
Parent organization
DAVID WICHNOSKI OD PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 13, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. David J Wichnoski, ODNPI 1790866069
Title
President
Phone
(704) 543-9000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 1632 NC Primary

Addresses

Primary practice location

200 S College St Ste 307
Charlotte, NC 28202-2065

Mailing address

7615 Colony Rd
Charlotte, NC 28226-5017
Phone (704) 543-9000

Other names 1

  • Spectrum Eyecare Doing business as

National Provider Directory

National Provider Directory
Tax ID family
David Wichnoski OD PA3 organizations share this tax ID, including this one
Part of
David Wichnoski OD PA

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

7615 Colony Rd
Charlotte, NC 28226
Phone (704) 365-4545

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355356800000",
    "number": "1013253418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7615 COLONY RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282265017",
            "telephone_number": "704-543-9000",
            "fax_number": "704-543-9002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 S COLLEGE ST STE 307",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282022065",
            "telephone_number": "704-334-4444",
            "fax_number": "704-334-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID WICHNOKSI OD PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DAVID WICHNOSKI OD PA",
        "enumeration_date": "2012-12-13",
        "last_updated": "2012-12-13",
        "status": "A",
        "authorized_official_last_name": "WICHNOSKI",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-543-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spectrum Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.