Active NPI
Denise Wilson, O.D.
- Optometrist
- Novi, MI
National Provider Identifier
1275611758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 4901002778
- Practice address
- 27300 Wixom Rd
Novi, MI 48374-1120 - Phone
- (248) 349-6379
- NPI assigned
- Nov 1, 2006
- Last updated
- Nov 30, 2020
- 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 | 4901002778 | MI | Primary |
Addresses
Primary practice location
27300 Wixom Rd
Novi, MI 48374-1120
Mailing address
49676 Timber TRL
Novi, MI 48374-2162
Phone (248) 505-3214
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- 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
- Ferris State College - College of Optometry, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1794 N Old US
23 Designs for Eyes
Howell, MI 48843-7193
Phone (810) 632-7444
31020 John R Rd
Madison Heights, MI 48071-1908
Phone (248) 589-1349
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4901002778 | MI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cripe Holdings LLC | Single Specialty | Current | Accepting new patients |
| Kat Stannis LLC | Single Specialty | Current | Accepting new patients |
Locations
1794 N Old US 23
Howell, MI 48843
Phone (810) 632-7444
Organizations & group practices 3
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.
-
- Optometrist
- Highland, MI
- NPI 1144579368
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1606694400000",
"number": "1275611758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "49676 TIMBER TRL",
"city": "NOVI",
"state": "MI",
"postal_code": "483742162",
"telephone_number": "248-505-3214",
"fax_number": "248-349-3874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "27300 WIXOM RD",
"city": "NOVI",
"state": "MI",
"postal_code": "483741120",
"telephone_number": "248-349-6379"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "DENISE",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2020-11-30",
"certification_date": "2020-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MI",
"license": "4901002778",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Novi, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2020; 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.