Organization Active NPI

Wilkerson Eye Care, PLLC

  • Optometrist
  • Tahlequah, OK
National Provider Identifier
1508693409
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
WILKERSON EYE CARE, PLLC
Practice address
209 Woodlawn Ave
Tahlequah, OK 74464-3317
Phone
(918) 822-3696
NPI assigned
Sep 16, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Authorized official

Name
Kari Wilkerson, ODNPI 1083167027
Title
Optometrist
Phone
(918) 822-3696

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

209 Woodlawn Ave
Tahlequah, OK 74464-3317

Mailing address

13763 N 535 Rd
Tahlequah, OK 74464-0374
Phone (918) 822-3696

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250505001235 OK Part B Supplier - Clinic/Group Practice 7911424999 Receives reassigned benefits from 1 practitioner
Practice locations: Tahlequah, OK

National Provider Directory

National Provider Directory

Locations

209 Woodlawn Ave
Tahlequah, OK 74464
Phone (918) 456-0585

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1508693409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13763 N 535 RD",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744640374",
            "telephone_number": "918-822-3696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 WOODLAWN AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643317",
            "telephone_number": "918-822-3696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILKERSON EYE CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "WILKERSON",
        "authorized_official_first_name": "KARI",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "918-822-3696",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.