Organization Active NPI

Whitson Vision PC

  • Ophthalmology Physician
  • Mooresville, IN
National Provider Identifier
1457377905
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
01036301A Issued in IN
Legal business name
WHITSON VISION PC
Practice address
1201 Hadley Rd
Suite 203
Mooresville, IN 46158-1737
Phone
(317) 217-3937
Fax
(317) 217-3950
NPI assigned
Jul 15, 2006
Last updated
Jun 25, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2008

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

Authorized official

Name
William E Whitson, MDNPI 1912935313
Title
Owner
Phone
(317) 844-5500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18002221A IN
Ophthalmology Physician 207W00000X 01036301A IN Primary

Addresses

Primary practice location

1201 Hadley Rd
Suite 203
Mooresville, IN 46158-1737

Mailing address

901 E 86TH St
Indianapolis, IN 46240-1807
Phone (317) 844-5500

Other identifiers 2

IdentifierTypeStateIssuer
000000102683OtherINBC/BS GROUP #
100072590MedicaidIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040916001235 IN Part B Supplier - Clinic/Group Practice 9931177029 Receives reassigned benefits from 10 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brownsburg, IN; Indianapolis, IN

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1201 Hadley Rd
Ste 203
Mooresville, IN 46158
Phone (317) 217-3937

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214352000000",
    "number": "1457377905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 E 86TH ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401807",
            "telephone_number": "317-844-5500",
            "fax_number": "317-573-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 HADLEY RD",
            "address_2": "SUITE 203",
            "city": "MOORESVILLE",
            "state": "IN",
            "postal_code": "461581737",
            "telephone_number": "317-217-3937",
            "fax_number": "317-217-3950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITSON VISION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-15",
        "last_updated": "2008-06-25",
        "status": "A",
        "authorized_official_last_name": "WHITSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "317-844-5500",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18002221A",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IN",
            "license": "01036301A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS GROUP #",
            "identifier": "000000102683",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100072590",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.