Individual provider Active NPI

Joshua David Wilson, O.D.

  • Optometrist
  • Nashville, IL
National Provider Identifier
1093740821
Registry record updated Feb 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.009850 Issued in IL
Practice address
250 E Elm St
Nashville, IL 62263-1710
Phone
(618) 327-3231
Fax
(618) 327-8748
NPI assigned
Jul 11, 2006
Last updated
Feb 7, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.009850 IL Primary
Optometrist 152W00000X 2006018214 MO

Addresses

Primary practice location

250 E Elm St
Nashville, IL 62263-1710

Mailing address

250 E Elm St
Nashville, IL 62263-1710
Phone (618) 327-3231

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20080402000312 IL Practitioner - Optometry 8325138159 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Missouri St Louis - School of Optometry, 2006
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)

821 W Hwy 50
O Fallon, IL 62269-1828
Phone (618) 680-2020

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

ProcedureNumber of procedures
Cataract surgery22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.009850ILMDOptometrist
2006018214MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Avc Optometry Inc Optometrist CurrentSince Apr 1, 2021 Accepting new patients
Avc Optometry Inc Optometrist CurrentSince Apr 1, 2021 Accepting new patients
Granite City Vision, Inc. Optometrist PastSince Sep 1, 2019 Accepting new patients
Vision Care Consultants Inc Optometrist PastSince Aug 3, 2001 Accepting new patients

Locations

3540 N Belt W
Ste C
Belleville, IL 62226
Phone (618) 235-4433

840 Admiral Weinel Blvd
Columbia, IL 62236
Phone (618) 281-2929

1200 N State St
Freeburg, IL 62243
Phone (618) 539-5620

250 E Elm St
Nashville, IL 62263
Phone (618) 327-3231

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1093740821",
    "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": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JOSHUA",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.009850",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "2006018214",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, IL

Sources for this page

Verify at the official NPI Registry.