NPIMap

Organization Active NPI

Willard C Pearce Jr OD PA

  • Optometrist
  • Lake Wales, FL
National Provider Identifier
1144201385
Registry record updated Sep 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPC1299 Issued in FL
Legal business name
WILLARD C PEARCE JR OD PA
Practice address
254 E Stuart Ave
Lake Wales, FL 33853-5720
Phone
(863) 676-2020
Fax
(863) 676-4500
NPI assigned
Nov 7, 2005
Last updated
Sep 10, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2007

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

Authorized official

Name
Dr. Willard Cail Pearce Jr., ODNPI 1386832905
Title
President
Phone
(863) 676-2020

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X OPC1299 FL Primary

Addresses

Primary practice location

254 E Stuart Ave
Lake Wales, FL 33853-5720

Mailing address

254 E Stuart Ave
PO Box 3806
Lake Wales, FL 33853-5720
Phone (863) 676-2020

National Provider Directory

National Provider Directory

Locations

254 E Stuart Ave
Lake Wales, FL 33853
Phone (863) 676-2020

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189382400000",
    "number": "1144201385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "254 E STUART AVE",
            "address_2": "PO BOX 3806",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338535720",
            "telephone_number": "863-676-2020",
            "fax_number": "863-676-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "254 E STUART AVE",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338535720",
            "telephone_number": "863-676-2020",
            "fax_number": "863-676-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLARD C PEARCE JR OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2007-09-10",
        "status": "A",
        "authorized_official_last_name": "PEARCE",
        "authorized_official_first_name": "WILLARD",
        "authorized_official_middle_name": "CAIL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "863-676-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC1299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wales, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.