Organization Active NPI

Wedo Eyes LLC

  • Optometrist
  • Tupelo, MS
National Provider Identifier
1205513660
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
WEDO EYES LLC
Practice address
3833 N Gloster St
Tupelo, MS 38804-0914
Phone
(662) 269-0856
Fax
(662) 269-0856
NPI assigned
Jun 28, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Authorized official

Name
Joshua Hunter Wilson, ODNPI 1255874368
Title
Owner
Phone
(662) 832-1609

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

3833 N Gloster St
Tupelo, MS 38804-0914

Mailing address

411 Eric CV
Oxford, MS 38655-5393
Phone (662) 269-0856

Other names 1

  • WeDo Eyes Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230719000992 MS Part B Supplier - Clinic/Group Practice 3779943907 Receives reassigned benefits from 1 practitioner
Practice locations: Tupelo, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1205513660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 ERIC CV",
            "city": "OXFORD",
            "state": "MS",
            "postal_code": "386555393",
            "telephone_number": "662-269-0856",
            "fax_number": "662-269-0856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3833 N GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388040914",
            "telephone_number": "662-269-0856",
            "fax_number": "662-269-0856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEDO EYES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "HUNTER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-832-1609",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WeDo Eyes",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tupelo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.