Nathan M Wadkins

Primary specialty

OpticianTaxonomy code 156FX1800X

License

271288 Issued in KY

Practice address

467 Jordan Dr Ste 102
Paducah, KY 42001-7499

Phone

(270) 297-2020

Fax

(270) 297-2020

NPI assigned

Mar 1, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Success Vision Express of Paducah, LLC

  dba Success Vision Express of Paducah

  • Optician
  • Paducah, KY
  • NPI 1851912687
  NPD

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

{
    "created_epoch": "1646092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1326794199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5312 W 41ST ST",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741076110",
            "telephone_number": "918-800-2020",
            "fax_number": "877-464-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "467 JORDAN DR STE 102",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420017499",
            "telephone_number": "270-297-2020",
            "fax_number": "270-297-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADKINS",
        "first_name": "NATHAN",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-01",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "KY",
            "license": "271288",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMONWEALTH OF KENTUCKY BOARD OF OPHTHALMIC DISPENSERS",
            "identifier": "271288",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Vorbeck
• W & J Harmon Inc (Purchase Ear Technology)
• Katelin Waddell
• Timothy E Waddell, PTA
• Brittney Michelle Wade, PHLEBOTOMIST
• Christian Oneal Waggoner, YPSS CERTIFED
• Renee Collette Waggoner, MS RD LD
• Christina Ruth Wagner, M.D.
• Madison Kate Wagner
• Allie R Wagoner

• Optician in Paducah, KY
• Providers in Paducah, KY by specialty
• Optician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.