Gary H. Wheeler, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1095T Issued in OR

Practice address

309 Genessee St
Medford, OR 97504-7107

Phone

(541) 779-2095

Fax

(541) 779-0667

NPI assigned

Oct 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OR

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196726400000",
    "number": "1316936214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 GENESSEE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047107",
            "telephone_number": "541-779-2095",
            "fax_number": "541-779-0667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 GENESSEE ST",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "975047107",
            "telephone_number": "541-779-2095",
            "fax_number": "541-779-0667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "GARY",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2007-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "1095T",
            "primary": true
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OR",
            "license": "1095T",
            "primary": false
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "OR",
            "license": "1095T",
            "primary": false
        },
        {
            "code": "152WP0200X",
            "taxonomy_group": "",
            "desc": "Optometrist, Pediatrics",
            "state": "OR",
            "license": "1095T",
            "primary": false
        },
        {
            "code": "152WS0006X",
            "taxonomy_group": "",
            "desc": "Optometrist, Sports Vision",
            "state": "OR",
            "license": "1095T",
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "",
            "desc": "Optometrist, Occupational Vision",
            "state": "OR",
            "license": "1095T",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SUPPLY PIN",
            "identifier": "0443320001",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "A003",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sophie A Westrud, WHCNP
• Mary Wetherell
• Phyllis M Wetzel, RN
• Travis Whalen, LMT
• Chelnitia Marie Wheeler
• Richard J Wheeler, CRM
• Courtney L Wheelock, FNP-C
• Theresa M Whipple
• Michelle Jo Whipps
• Carol Lynn Whitaker, L.C.S.W

• Optometrist in Medford, OR
• Providers in Medford, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.