Organization Active NPI

Emanuel Wilkes, M.D.,P.C.

  • Ophthalmology Physician
  • Columbus, GA
National Provider Identifier
1386852820
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
28335 Issued in GA
Legal business name
EMANUEL WILKES, M.D.,P.C.
Practice address
822 22ND Street
Columbus, GA 31904
Phone
(706) 327-9965
Fax
(706) 327-7798
NPI assigned
May 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Emanuel Wilkes, M.D.NPI 1518061944
Title
Owner
Phone
(706) 327-9965

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 28335 GA Primary

Addresses

Primary practice location

822 22ND Street
Columbus, GA 31904

Mailing address

822 22ND Street
Columbus, GA 31904
Phone (706) 327-9965

Other identifiers 2

IdentifierTypeStateIssuer
322056OtherGAWELLCARE MEDICAID
52237056-001OtherGAGA BCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080627000397 GA Part B Supplier - Clinic/Group Practice 4880766393 Receives reassigned benefits from 1 practitioner
Practice locations: Columbus, GA

National Provider Directory

National Provider Directory

Locations

822 22nd St
Columbus, GA 31904
Phone (706) 327-9965

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386852820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "822 22ND STREET",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31904",
            "telephone_number": "706-327-9965",
            "fax_number": "706-327-7798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "822 22ND STREET",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "31904",
            "telephone_number": "706-327-9965",
            "fax_number": "706-327-7798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMANUEL WILKES, M.D.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WILKES",
        "authorized_official_first_name": "EMANUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-327-9965",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "GA",
            "license": "28335",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE MEDICAID",
            "identifier": "322056",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA BCBS",
            "identifier": "52237056-001",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.