Peggy Lynn Wike, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1130 Issued in NC

Practice address

622 N Main St
Mooresville, NC 28115-2312

Phone

(704) 664-5406

Fax

(704) 663-6498

NPI assigned

Jul 19, 2005

Reactivated

Apr 5, 2006

Sex

Female

Sole proprietor

No

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

Enrolled in NC

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

Specialty

Optometry

Education

Southern College of Optometry, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Optometric Eye Clinic, P.a.

  • Optometrist
  • Mooresville, NC
  • NPI 1295030989
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303171200000",
    "number": "1386643757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 359",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281150359",
            "telephone_number": "704-664-5406",
            "fax_number": "704-663-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "622 N MAIN ST",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281152312",
            "telephone_number": "704-664-5406",
            "fax_number": "704-663-6498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIKE",
        "first_name": "PEGGY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-19",
        "last_updated": "2011-04-19",
        "deactivation_date": "2006-03-20",
        "reactivation_date": "2006-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "1130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7909969",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marie Ethel White, COTA/L
• Nicole A Whitehead, D.C.
• Meredith Whitlow, MT-BC
• Sheila Thornton Whitman, FNP
• Jillian Elizabeth Wiggill, MSOT, OTR
• Sydney Wilson Wike, COTA/L
• Brittany Marie Wilber, OT/L
• Wilder Wellness Center
• Hannah Kathryn Wilder
• William Frank Wilder III, M.A., LPC

• Optometrist in Mooresville, NC
• Providers in Mooresville, NC by specialty
• Optometrist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.