Redwell & Wieties Eyecare

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-007815 Issued in IL

Legal business name

REDWELL & WIETIES EYECARE

Practice address

905 W Mefford St
Robinson, IL 62454-1065

Phone

(618) 544-3525

Fax

(618) 544-3261

NPI assigned

Nov 27, 2012

Organization subpart

No

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

Authorized official

Name

Mr. William H Bedwell, O.D.

Title

Partner / Optometrist

Phone

(618) 544-3525

Specialties & licenses 2

Addresses

Other identifiers 4

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

{
    "created_epoch": "1353974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353974400000",
    "number": "1356686604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 658",
            "address_2": "905 W. MEFFORD ST.",
            "city": "ROBINSON",
            "state": "IL",
            "postal_code": "624541065",
            "telephone_number": "618-544-3525",
            "fax_number": "618-544-3261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "905 W MEFFORD ST",
            "city": "ROBINSON",
            "state": "IL",
            "postal_code": "624541065",
            "telephone_number": "618-544-3525",
            "fax_number": "618-544-3261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDWELL & WIETIES EYECARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-27",
        "last_updated": "2012-11-27",
        "status": "A",
        "authorized_official_last_name": "BEDWELL",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PARTNER / OPTOMETRIST",
        "authorized_official_telephone_number": "618-544-3525",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-007815",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008222",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "WIETIES P01082010",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "WIETIES 046-008222",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "BEDWELL 0790230001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BEDWELL 046-007815",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Robinson, IL
• Providers in Robinson, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; 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.