Active NPI
Stephanie Wilken, OD
- Optometrist
- Coppell, TX
National Provider Identifier
1265444111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 5763T
- Practice address
- 755 N Denton Tap Rd
#100
Coppell, TX 75019-2120 - Phone
- (972) 459-3300
- Fax
- (972) 459-0200
- NPI assigned
- Aug 12, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 5763T | TX | Primary |
Addresses
Primary practice location
755 N Denton Tap Rd
#100
Coppell, TX 75019-2120
Mailing address
755 N Denton Tap Rd
#100
Coppell, TX 75019-2120
Phone (972) 459-3300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 81322Q | Other | TX | BCBS OF TEXAS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of Houston - College of Optometry, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
755 N Denton Tap Rd
Suite 100
Coppell, TX 75019-2120
Phone (972) 459-3300
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
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 and National Provider Directory roles.
-
- Optometrist
- Coppell, TX
- NPI 1316140387
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155340800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360108800000",
"number": "1265444111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "755 N DENTON TAP RD",
"address_2": "#100",
"city": "COPPELL",
"state": "TX",
"postal_code": "750192120",
"telephone_number": "972-459-3300",
"fax_number": "972-459-0200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "755 N DENTON TAP RD",
"address_2": "#100",
"city": "COPPELL",
"state": "TX",
"postal_code": "750192120",
"telephone_number": "972-459-3300",
"fax_number": "972-459-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKEN",
"first_name": "STEPHANIE",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-12",
"last_updated": "2013-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "5763T",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TEXAS",
"identifier": "81322Q",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coppell, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2013; 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.