Individual provider Active NPI

Bret Wilmon, OD

  • Optometrist
  • Purcell, OK
National Provider Identifier
1285289694
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3048 Issued in OK
Practice address
1438 Hardcastle Blvd
Purcell, OK 73080-8233
Phone
(405) 527-4700
NPI assigned
Aug 3, 2019
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3048 OK Primary

Addresses

Primary practice location

1438 Hardcastle Blvd
Purcell, OK 73080-8233

Mailing address

1925 Warrior Way
Ada, OK 74820-3491
Phone (580) 421-4570

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191029001613 TX Practitioner - Optometry 1254663099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1438 Hardcastle Blvd
Purcell, OK 73080-8233
Phone (405) 527-4700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3048OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chickasaw Nation Division of Health CurrentSince Oct 10, 2019 Accepting new patients
Chickasaw Nation Division of Health Chickasaw Nation Medical Center CurrentSince Oct 10, 2019 Accepting new patients
Chickasaw Nation Division of Health Chickasaw Nation Medical Center Past Accepting new patients

Locations

1921 Stonecipher Dr
Ada, OK 74820
Phone (580) 421-4570

1925 Warrior Way
Ada, OK 74820

2510 Chickasaw Blvd
Ardmore, OK 73401
Phone (580) 226-8181

1438 Hardcastle Blvd
Purcell, OK 73080
Phone (405) 527-4700

817 E 6th St
Tishomingo, OK 73460
Phone (580) 371-2392

Interoperability endpoints

  • Direct secure messaging: bwilmon22360@direct.chickasawnationhealth.net

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1564790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1285289694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 WARRIOR WAY",
            "city": "ADA",
            "state": "OK",
            "postal_code": "748203491",
            "telephone_number": "580-421-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1438 HARDCASTLE BLVD",
            "city": "PURCELL",
            "state": "OK",
            "postal_code": "730808233",
            "telephone_number": "405-527-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILMON",
        "first_name": "BRET",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-03",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OK",
            "license": "3048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Purcell, OK

Sources for this page

Verify at the official NPI Registry.