David Russell Wilson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OEG001476 Issued in PA

Practice address

650 E High St
Ste 652
Carlisle, PA 17013

Phone

(717) 258-4422

Fax

(717) 258-4245

NPI assigned

Oct 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in MD, PA, VA3 enrollments

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 3

Specialty

Optometry

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Myeyedr Optometry of Pennsylvania LLCGroup PAC ID 3971884883, 118 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Myeyedr Optometry of Pennsylvania, LLC

  dba MyEyeDr.

  • Optometrist
  • Carlisle, PA
  • NPI 1003264607
  Medicare reassignment Care Compare group NPD
• Myeyedr Optometry of Maryland, LLC

  dba MyEyeDr

  • Optometrist
  • Waldorf, MD
  • NPI 1609204437
  Medicare reassignment NPD
• Myeyedr Optometry of Virginia PLLC

  dba MyEyeDr

  • Optometrist
  • Ashburn, VA
  • NPI 1174933691
  Medicare reassignment NPD
• Myeyedr Optometry of Pennsylvania, LLC

  • Optometrist
  • Cranberry Township, PA
  • NPI 1093688491
  NPD
• Myeyedr Optometry of Maryland, LLC

  dba Myeyedr

  • Optometrist
  • Elkton, MD
  • NPI 1790167948
  NPD
• Myeyedr Optometry of Maryland, LLC

  dba MyEyeDr.

  • Optometrist
  • Laurel, MD
  • NPI 1972900058
  NPD
• Myeyedr Optometry of Virginia, PLLC

  dba MyEyeDr.

  • Optometrist
  • Winchester, VA
  • NPI 1306294145
  NPD
• Myeyedr Optometry of Virginia, PLLC

  • Optometrist
  • North Chesterfield, VA
  • NPI 1932075983
  NPD
• Allegany Optical LLC

  dba Allegany Optical

  • Optometrist
  • Carlisle, PA
  • NPI 1851572200
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Silver Spring Optometry, LLC

  dba My Eye Dr

  • Optometrist
  • Silver Spring, MD
  • NPI 1336204387
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407931629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19336 LEITERSBURG PIKE",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "21742",
            "telephone_number": "717-258-4422",
            "fax_number": "717-258-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 E HIGH ST",
            "address_2": "STE 652",
            "city": "CARLISLE",
            "state": "PA",
            "postal_code": "17013",
            "telephone_number": "717-258-4422",
            "fax_number": "717-258-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DAVID",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PA",
            "license": "OEG001476",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1894",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618001399",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUE CROSS BLUE",
            "identifier": "64392302",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011408310002",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BLUE SHIELD",
            "identifier": "WI1634058",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Julie Benner White, LPTA
• Amanda Wilcox
• Erin Nicole Wilfong, R.N.
• Jaclyn K Williams, PA
• Thomas G Williams Jr., PHARM.D.
• Amanda C Wilston
• Joseph Paul Winberry Jr., OD
• Karissa Wincell, MS
• Lauren Michaud Winn, MD
• Daniel Witkiewicz

• Optometrist in Carlisle, PA
• Providers in Carlisle, PA by specialty
• Optometrist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.