Individual provider Active NPI

Caswell Hughes Wadley, O. D.

  • Optometrist
  • Pulaski, TN
National Provider Identifier
1427088178
Registry record updated Jun 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1309 Issued in TN
Practice address
118 N 3Rd St
Pulaski, TN 38478-3200
Phone
(931) 363-4557
Fax
(931) 424-0778
NPI assigned
Jul 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1309 TN Primary

Addresses

Primary practice location

118 N 3Rd St
Pulaski, TN 38478-3200

Mailing address

PO Box 1129
Pulaski, TN 38478-1129
Phone (931) 363-4557

Other identifiers 1

IdentifierTypeStateIssuer
3597789MedicaidTN

Other names 1

  • Dr. C. Hughes Wadley Other name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20110817000154 TN Practitioner - Optometry 9032226519 Reassigns benefits to 1 organization
Practice locations: Pulaski, TN

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pulaski Eye Care, Inc. Optometrist CurrentSince Aug 13, 2021 Accepting new patients

Locations

1125 E College St
Pulaski, TN 38478
Phone (931) 363-4554

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371686400000",
    "number": "1427088178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1129",
            "city": "PULASKI",
            "state": "TN",
            "postal_code": "384781129",
            "telephone_number": "931-363-4557",
            "fax_number": "931-424-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 N 3RD ST",
            "city": "PULASKI",
            "state": "TN",
            "postal_code": "384783200",
            "telephone_number": "931-363-4557",
            "fax_number": "931-424-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WADLEY",
        "first_name": "CASWELL",
        "middle_name": "HUGHES",
        "name_prefix": "Dr.",
        "credential": "O. D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2013-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "1309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3597789",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "C.",
            "last_name": "WADLEY",
            "middle_name": "HUGHES",
            "prefix": "DR.",
            "credential": "O. D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Pulaski, TN

Sources for this page

Verify at the official NPI Registry.