Roger W Wilson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

18003054A Issued in IN

Practice address

1551 E Stop 12 Rd
Indianapolis, IN 46227-1006

Phone

(317) 883-4970

NPI assigned

Jul 31, 2006

Sex

Male

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 IN

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

Indiana University - School of Optometry, 1999

Medicare assignment

May accept Medicare assignment

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.

• PHB Vision Group, P.C.

  • Optometrist
  • Fort Wayne, IN
  • NPI 1346105723

  IN

  Medicare reassignment
• Wisconsin Vision, Inc

  • Optometrist
  • Kokomo, IN
  • NPI 1871631978
  NPD
• Wisconsin Vision, LLC

  • Optometrist
  • New Berlin, WI
  • NPI 1134179427
  NPD
• Wisconsin Vision, LLC

  • Optometrist
  • Brookfield, WI
  • NPI 1457890220
  NPD

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199404800000",
    "number": "1427064385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 WAKEFIELD DR E",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461428801",
            "telephone_number": "317-881-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 E STOP 12 RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462271006",
            "telephone_number": "317-883-4970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ROGER",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003054A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED VISION NO.",
            "identifier": "IN3054",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Quiana Wilson
• Rachael Wilson
• Reid G Wilson, MD
• Richard Lewis Wilson, RPH
• Riley Wilson
• Ronnie Hakeem Wilson
• Ryan Wilson, LCSW
• Rylan Brooks Wilson
• Samantha Skinner Wilson, MD
• Samantha Stone Wilson, M.S., CF-SLP

• Optometrist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Optometrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2008; 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.