Laura Wilshire, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-011052 Issued in IL

Practice address

8309 N Knoxville Ave
Ste. 1
Peoria, IL 61615-2170

Phone

(309) 713-3664

Fax

(309) 693-9754

NPI assigned

Aug 2, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Laura Spiker Former name

Medicare fee-for-service enrollment

Enrolled in IL

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

University of Missouri St Louis - School of Optometry, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vep Il Optometric LLCGroup PAC ID 3678814217, 27 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Vep Il Optometric LLC

  • Optometrist
  • Bloomington, IL
  • NPI 1528536620
  Medicare reassignment Care Compare group NPD
• J a K Enterprises Inc

  • Durable Medical Equipment & Medical Supplies
  • Pontiac, IL
  • NPI 1255617924

  Optometrist

  NPD (past)
• Oneopto Il 2 PLLC

  • Optometrist
  • Bloomington, IL
  • NPI 1003788431
  NPD (past)

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

{
    "created_epoch": "1470096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470096000000",
    "number": "1063965515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8309 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152170",
            "telephone_number": "309-693-9540",
            "fax_number": "309-693-9754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8309 N KNOXVILLE AVE",
            "address_2": "STE. 1",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152170",
            "telephone_number": "309-713-3664",
            "fax_number": "309-693-9754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSHIRE",
        "first_name": "LAURA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-02",
        "last_updated": "2016-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-011052",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046011052",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "SPIKER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Judith Lynn Williamson, RN, APRN-BC, FNP,
• Matthew Joseph Willis, APN
• Sue Willis, PTA
• Jennifer N Willman, CNP
• Delinda Demita Wills, MD
• Wilson Eye Care Center LTD
• Laura L Wilson-Brown, P.A.
• Angela Wilson, PMHNP-BC
• Dani Wilson
• James P Wilson, OD

• Optometrist in Peoria, IL
• Providers in Peoria, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; 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.