Sidney Maurice Wilson, O.D.

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

568 Issued in MS

Practice address

6745 S Siwell Rd
Suite 106
Byram, MS 39272-8700

Phone

(601) 373-0354

Fax

(601) 373-0321

NPI assigned

Feb 17, 2007

Last updated

Feb 17, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS

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

Southern College of Optometry, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aaron E Henry Community HealthGroup PAC ID 1153230560, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• LA PPO C-SNP

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GGGCCD/Endpoint/GGGCCD
• Direct secure messaging: sidney.wilson@aehchc.eclinicaldirectplus.com

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.

• Aaron E Henry Community Health

  • Federally Qualified Health Center (FQHC)
  • Batesville, MS
  • NPI 1003814104
  Medicare reassignment Care Compare group NPD
• Aaron E. Henry Community Health Services Center, Inc

  • Pediatrics Physician
  • Clarksdale, MS
  • NPI 1134868672
  NPD
• Aaron E Henry Community Health

  dba Aaron E Henry Mobile Medical Unit #3

  • Federally Qualified Health Center (FQHC)
  • Clarksdale, MS
  • NPI 1063756716
  NPD (past)
• Optical 2000

  • Optometrist
  • Clinton, MS
  • NPI 1144422577
  NPD (past)
• Optical 2000 of Flora PA

  • Optometrist
  • Flora, MS
  • NPI 1447794797
  NPD (past)

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

{
    "created_epoch": "1171670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297900800000",
    "number": "1093859563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6745 S SIWELL RD",
            "address_2": "SUITE 106",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392728700",
            "telephone_number": "601-373-0354",
            "fax_number": "601-373-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6745 S SIWELL RD",
            "address_2": "SUITE 106",
            "city": "BYRAM",
            "state": "MS",
            "postal_code": "392728700",
            "telephone_number": "601-373-0354",
            "fax_number": "601-373-0321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SIDNEY",
        "middle_name": "MAURICE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-17",
        "last_updated": "2011-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MS",
            "license": "568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02229351",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Regina S Wilcox-Lewis, LCSW
• Corey Wilder, PHARMD
• Shavvone Williams
• Sheila Elaine Williams
• Chasity Willis
• Anthony Dwayne Witherspoon, D.C.
• Dconstance Woodard, LCSW
• Lisa Yazdani, PH.D.
• Angelia Jean Yelverton, FNP
• David Hunter Yentzen, ATC

• Corneal and Contact Management Optometrist in Byram, MS
• Providers in Byram, MS by specialty
• Corneal and Contact Management Optometrist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; 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.