Active NPI
Wilson Polito PLLC
Doing business as Alpine Vision Center
- Optometrist
- Moscow, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- ODP 100-222
- Legal business name
- WILSON POLITO PLLC
- Practice address
- 1844 W Pullman Rd
Moscow, ID 83843-4014 - Phone
- (208) 883-1800
- Fax
- (208) 883-1811
- NPI assigned
- Jan 9, 2017
- Last updated
- Jun 3, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Nathan Michael Wilson, OD
- Title
- President
- Phone
- (208) 743-5830
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | ODP 100-222 | ID | Primary |
Addresses
Primary practice location
1844 W Pullman Rd
Moscow, ID 83843-4014
Mailing address
1844 W Pullman Rd
Moscow, ID 83843-4014
Phone (208) 883-1800
Other names 2
- Alpine Vision Center
- Wilson Polito Inc
National Provider Directory
National Provider Directory- Tax ID family
- Alpine Vision Center
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Optometrist
- Northglenn, CO
- NPI 1164523643
-
- Optometrist
- Northglenn, CO
- NPI 1306947874
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1483920000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1622678400000",
"number": "1285170696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1844 W PULLMAN RD",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838434014",
"telephone_number": "208-883-1800",
"fax_number": "208-883-1811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1844 W PULLMAN RD",
"city": "MOSCOW",
"state": "ID",
"postal_code": "838434014",
"telephone_number": "208-883-1800",
"fax_number": "208-883-1811"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WILSON POLITO PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-01-09",
"last_updated": "2021-06-03",
"certification_date": "2020-11-06",
"status": "A",
"authorized_official_last_name": "WILSON",
"authorized_official_first_name": "NATHAN",
"authorized_official_middle_name": "MICHAEL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "208-743-5830",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "OD"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "ID",
"license": "ODP 100-222",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Alpine Vision Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Wilson Polito Inc",
"code": "4",
"type": "Former Legal Business Name"
},
{
"organization_name": "Alpine Vision Center",
"code": "5",
"type": "Other Name"
},
{
"organization_name": "Alpine Vision Center",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Moscow, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.