Eye Care on the Ridge LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618001276 Issued in VA

Legal business name

EYE CARE ON THE RIDGE LLC

Practice address

843 W Stuart Dr
Hillsville, VA 24343-1577

Phone

(276) 728-9323

NPI assigned

May 4, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Shad L Wheatley, O.D.NPI 1821077686

Title

Optometrist

Phone

(276) 728-9323

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 8

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

• Shad L Wheatley, OD

  • Optometrist
  • Hillsville, VA
  • NPI 1821077686
  Medicare reassignment Care Compare group NPD Authorized official
• Adam English, OD

  • Optometrist
  • Hillsville, VA
  • NPI 1447708078
  Medicare reassignment Care Compare group NPD
• Sarah Erwin, O.D

  • Optometrist
  • Fairlawn, VA
  • NPI 1497137871
  Medicare reassignment Care Compare group NPD
• Keith Boe Gagnon, DO

  • Optometrist
  • Hillsville, VA
  • NPI 1558117721
  Medicare reassignment Care Compare group NPD
• Warren Gwynn, O.D, M.S.

  • Optometrist
  • Hillsville, VA
  • NPI 1649685629
  Medicare reassignment Care Compare group NPD
• Emily Sikes Petanovich, O.D.

  • Optometrist
  • Hillsville, VA
  • NPI 1235689613
  Medicare reassignment Care Compare group NPD
• Thomas Nielsen Gwynn, HIS

  • Hearing Instrument Specialist
  • Hillsville, VA
  • NPI 1902366800
  NPD (past)
• Justin Mark Rowe, O.D.

  • Optometrist
  • McCall, ID
  • NPI 1598954638
  NPD (past)

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

{
    "created_epoch": "1304467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314748800000",
    "number": "1063704435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "843 W STUART DR",
            "city": "HILLSVILLE",
            "state": "VA",
            "postal_code": "243431577",
            "telephone_number": "276-728-9323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "843 W STUART DR",
            "city": "HILLSVILLE",
            "state": "VA",
            "postal_code": "243431577",
            "telephone_number": "276-728-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE CARE ON THE RIDGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-04",
        "last_updated": "2011-08-31",
        "status": "A",
        "authorized_official_last_name": "WHEATLEY",
        "authorized_official_first_name": "SHAD",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "276-728-9323",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WHEATLEY NPI",
            "identifier": "1821077686",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Preston Hill Edwards, MD
• Medhat Elmasry, M.D.
• Adam English, OD
• Evernorth Direct Health LLC
• Exceptional Healthcare VA, Inc
• Family Medical Care, Inc.
• Family Preservation Services, Inc
• Jake Fizer
• Flex Fit Function PLLC
• Brian Franklin Fritz

• Optometrist in Hillsville, VA
• Providers in Hillsville, VA by specialty
• Optometrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.