Kent A. Wilson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4572TG Issued in TX

Practice address

808 W Moore Ave
Suite B
Terrell, TX 75160-3002

Phone

(972) 563-5533

Fax

(972) 524-8489

NPI assigned

Aug 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Vision, P.C.Group PAC ID 9739211046, 2 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dr.wilson@premiervision.eyefinity-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Premier Vision, P.C.

  • Optometrist
  • Terrell, TX
  • NPI 1093721821
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013924364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 W MOORE AVE",
            "address_2": "SUITE B",
            "city": "TERRELL",
            "state": "TX",
            "postal_code": "751603002",
            "telephone_number": "972-563-5533",
            "fax_number": "972-524-8489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 W MOORE AVE",
            "address_2": "SUITE B",
            "city": "TERRELL",
            "state": "TX",
            "postal_code": "751603002",
            "telephone_number": "972-563-5533",
            "fax_number": "972-524-8489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "KENT",
        "middle_name": "A.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "4572TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "80770Q",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany Wheeler
• Melanie Deanne Wheeler, LPC, LCDC
• Lindsey Nicole White
• Tramaine Williams, LPC
• Bridget Y Williford, LPC
• Samantha Wilson, LPA
• Winners Community Health Services, Inc.
• Winners Community Health Services, Inc.
• Winners Community Health Services, Incorporated
• Wonderful Living Inc.

• Optometrist in Terrell, TX
• Providers in Terrell, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.