Active NPI
Prathibha Srikantan Wilson, OD, MS
- Optometrist
- Las Vegas, NV
National Provider Identifier
1144978362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1181
- Practice address
- 6230 N Durango Dr
Las Vegas, NV 89149-3916 - Phone
- (702) 737-3937
- NPI assigned
- Mar 16, 2022
- Last updated
- Feb 12, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1181 | NV | Primary |
Addresses
Primary practice location
6230 N Durango Dr
Las Vegas, NV 89149-3916
Mailing address
6230 N Durango Dr
Las Vegas, NV 89149-3916
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NV
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Miller and Miller, OD LTD | Optometrist | Current | Accepting new patients |
Locations
6230 N Durango Dr
Las Vegas, NV 89149
Phone (702) 737-3937
Organizations & group practices 1
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": "1647388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707696000000",
"number": "1144978362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6230 N DURANGO DR",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891493916"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6230 N DURANGO DR",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891493916",
"telephone_number": "702-737-3937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "PRATHIBHA",
"middle_name": "SRIKANTAN",
"credential": "OD, MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-16",
"last_updated": "2024-02-12",
"certification_date": "2024-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NV",
"license": "1181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.