Individual provider Active NPI

Thomas Kent Wilcox, O.D.

  • Optometrist
  • Roanoke, VA
National Provider Identifier
1013993963
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
0618000148 Issued in VA
Practice address
4135 Franklin Rd
Roanoke, VA 24018-5703
Phone
(540) 776-2930
NPI assigned
Dec 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 0618000148 VA Primary

Addresses

Primary practice location

4135 Franklin Rd
Roanoke, VA 24018-5703

Mailing address

1507 Hershberger Rd NW Ste C
Roanoke, VA 24012-7300
Phone (540) 362-1030

Other practice location 1

4802 Valley View Blvd NW
Roanoke, VA 24012-2001
Phone (540) 563-8279

Other identifiers 1

IdentifierTypeStateIssuer
010005353MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0618000148VAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Thomas K. Wilcox, O.D. and Associates, P.C. Past Accepting new patients
Rockingham Eye Physicians & Associates, P.C. Optometrist PastSince Mar 30, 2025 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1013993963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 HERSHBERGER RD NW STE C",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240127300",
            "telephone_number": "540-362-1030",
            "fax_number": "540-362-5574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4135 FRANKLIN RD",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240185703",
            "telephone_number": "540-776-2930"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4802 Valley View Blvd NW",
            "address_purpose": "LOCATION",
            "city": "Roanoke",
            "state": "VA",
            "postal_code": "240122001",
            "country_code": "US",
            "telephone_number": "540-563-8279",
            "fax_number": "540-563-5598",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILCOX",
        "first_name": "THOMAS",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-21",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618000148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010005353",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.