Active NPI
Wade G Dulin, OD
- Optometrist
- Wichita, KS
National Provider Identifier
1013998558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1067-3
- Practice address
- 2330 Amidon Ave
Wichita, KS 67204-5630 - Phone
- (316) 838-7797
- Fax
- (316) 838-7809
- NPI assigned
- Nov 10, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1067-3 | KS | Primary |
Addresses
Primary practice location
2330 Amidon Ave
Wichita, KS 67204-5630
Mailing address
2330 Amidon Ave
Wichita, KS 67204-5630
Phone (316) 838-7797
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005119 | Other | KS | BCBS OF KANSAS |
| P00791194 | Other | KS | RR MEDICARE |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1067-3 | KS | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131580800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270512000000",
"number": "1013998558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2330 AMIDON AVE",
"city": "WICHITA",
"state": "KS",
"postal_code": "672045630",
"telephone_number": "316-838-7797",
"fax_number": "316-838-7809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2330 AMIDON AVE",
"city": "WICHITA",
"state": "KS",
"postal_code": "672045630",
"telephone_number": "316-838-7797",
"fax_number": "316-838-7809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DULIN",
"first_name": "WADE",
"middle_name": "G",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-10",
"last_updated": "2010-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "KS",
"license": "1067-3",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF KANSAS",
"identifier": "005119",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00791194",
"state": "KS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.