Michael Kenton Wilson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046011126 Issued in IL

Practice address

250 E Elm St
Nashville, IL 62263-1710

Phone

(618) 327-3231

Fax

(618) 327-8748

NPI assigned

May 11, 2017

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Avc Optometry IncGroup PAC ID 7214345735, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

98.99 of 100Reported as group

Quality

97.98

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Avc Optometry Inc

  dba Advanced Vision Care

  • Optometrist
  • Nashville, IL
  • NPI 1285214544
  Medicare reassignment Care Compare group NPD
• Avc Optometry Inc

  • Optometrist
  • Columbia, IL
  • NPI 1982348587
  NPD

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1083140966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 E ELM ST",
            "city": "NASHVILLE",
            "state": "IL",
            "postal_code": "622631710",
            "telephone_number": "618-327-3231",
            "fax_number": "618-327-8748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 E ELM ST",
            "city": "NASHVILLE",
            "state": "IL",
            "postal_code": "622631710",
            "telephone_number": "618-327-3231",
            "fax_number": "618-327-8748"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3540 N Belt W Ste C",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "622265975",
            "country_code": "US",
            "telephone_number": "618-235-4433",
            "fax_number": "618-235-7483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHAEL",
        "middle_name": "KENTON",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-11",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Washington County Hospital District
• Washington County Hospital District (Washington County Hospital)
• Washington County Vocational Workshop
• Harold Whitworth, C.R.N.A.
• Joshua David Wilson, O.D.
• Jerome Allen Wisehart
• Bonni S Yaekel

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

• 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.
• 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.