Active NPI
Andrew Wilson, O.D.
- Optometrist
- Camarillo, CA
National Provider Identifier
1477966026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 14926
- Practice address
- 4000 Calle Tecate
#100
Camarillo, CA 93012-5282 - Phone
- (805) 482-1136
- Fax
- (805) 388-8499
- NPI assigned
- Jun 10, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 14926 | CA | Primary |
Addresses
Primary practice location
4000 Calle Tecate
#100
Camarillo, CA 93012-5282
Mailing address
4000 Calle Tecate
Suite 100
Camarillo, CA 93012-5282
Phone (805) 482-1136
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14926 | CA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1402358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414627200000",
"number": "1477966026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4000 CALLE TECATE",
"address_2": "SUITE 100",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930125282",
"telephone_number": "805-482-1136",
"fax_number": "805-388-8499"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 CALLE TECATE",
"address_2": "#100",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930125282",
"telephone_number": "805-482-1136",
"fax_number": "805-388-8499"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-10",
"last_updated": "2014-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "14926",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camarillo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2014; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.