NPIMap

Organization Active NPI

Wedgwood Eyecare PC

Doing business as Visualeyes

  • Optometrist
  • Fort Worth, TX
National Provider Identifier
1376756858
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6055TG Issued in TX
Legal business name
WEDGWOOD EYECARE PC
Doing business as
Visualeyes
Practice address
6037 Harris Pkwy
Fort Worth, TX 76132-4103
Phone
(817) 294-2800
NPI assigned
May 8, 2007
Last updated
Jun 25, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Authorized official

Name
Dr. Keira R WestNPI 1073592028
Title
Owner
Phone
(817) 294-2800

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)CodeLicenseStatePrimary
Optometrist 152W00000X 6055TG TX Primary

Addresses

Primary practice location

6037 Harris Pkwy
Fort Worth, TX 76132-4103

Mailing address

6037 Harris Pkwy
Fort Worth, TX 76132-4103
Phone (817) 294-2800

Other names 1

  • VISUALEYES Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200630001973 TX Part B Supplier - Clinic/Group Practice 2961825450 Receives reassigned benefits from 3 practitioners
Practice locations: Fort Worth, TX

National Provider Directory

National Provider Directory

Locations

6037 Harris Pkwy
Fort Worth, TX 76132
Phone (817) 294-2800

6049 Harris Pkwy
Fort Worth, TX 76132
Phone (817) 294-2800

Practitioners & affiliated clinicians

Practitioners 33

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.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593043200000",
    "number": "1376756858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6037 HARRIS PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324103",
            "telephone_number": "817-294-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6037 HARRIS PKWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761324103",
            "telephone_number": "817-294-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEDGWOOD EYECARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "KEIRA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-294-2800",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6055TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VISUALEYES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "VISUALEYES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.