Alexandra Hollingshead Wilson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

ODP-100524 Issued in ID

Practice address

901 12TH Ave S
Nampa, ID 83651-4658

Phone

(208) 466-9251

NPI assigned

Feb 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Illinois College of Optometry at Chicago, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Daniel L Tiller PAGroup PAC ID 3476633801, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: holl0901@advancedeyecare.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Daniel L Tiller PA

  • Optometrist
  • Nampa, ID
  • NPI 1861485989
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1225620313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 12TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836514658",
            "telephone_number": "208-466-9251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 12TH AVE S",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836514658",
            "telephone_number": "208-466-9251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ALEXANDRA",
        "middle_name": "HOLLINGSHEAD",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-09",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ID",
            "license": "ODP-100524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vivian Williams, OTD, OTR/L
• Courtney Willis, DMD
• Willow Mental Health Counseling
• Adrienne Elizabeth Wilson, LMT
• Alex Allen Wilson
• Brian Mitchell Wilson, OTR
• Jacob W. Wilson, LCSW
• Kendall Ann Wilson
• Martha Clinton Wilson, MD
• Summer Ann Wilson, LCSW

• Optometrist in Nampa, ID
• Providers in Nampa, ID by specialty
• Optometrist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.