Richard C Wilson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

TO 3339 Issued in MO

Practice address

6708 Raytown Rd
Raytown, MO 64133-5272

Phone

(816) 353-1872

Fax

(816) 353-5022

NPI assigned

Dec 2, 2005

Last updated

Nov 12, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Paige Hedgpath OD,PC

  dba Eyes On Missouri

  • Optometrist
  • Jefferson City, MO
  • NPI 1962644732
  Medicare reassignment NPD
• Advanced Eyecare PC

  dba Blue Springs Optical

  • Optometrist
  • Blue Springs, MO
  • NPI 1528006426
  Authorized official Same address or phone
• Advanced Eyecare PC

  • Optometrist
  • Raytown, MO
  • NPI 1679510655
  Authorized official Same address or phone
• Advanced Eyecare, PC

  dba Advanced Eyecare South

  • Optometrist
  • Raymore, MO
  • NPI 1467760173
  Authorized official Same address or phone
• Paige Hedgpath Odpc

  dba Eyes On Missouri

  • Optometrist
  • Columbia, MO
  • NPI 1669530887
  NPD

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289520000000",
    "number": "1538143540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6708 RAYTOWN RD",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641335272",
            "telephone_number": "816-353-1872",
            "fax_number": "816-353-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6708 RAYTOWN RD",
            "city": "RAYTOWN",
            "state": "MO",
            "postal_code": "641335272",
            "telephone_number": "816-353-1872",
            "fax_number": "816-353-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "RICHARD",
        "middle_name": "C",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2010-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "TO 3339",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "KS",
            "license": "KS 1674",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "KS 1674",
            "state": "KS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "312239309",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "TO 3339",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410037607",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linnea Williams, DO
• Melissa L Williams, LPC
• Nathan Taylor Williamson, PTA
• Shirley Ann Williamson
• Nakia Danine Wilson, MSW, LCSW, LSCSW,RPT
• Sierra Wilson, DDS
• Leslie K Wiscombe, DO
• Michael Woodhead, DMD
• Wound Ostomy Leg & Foot Care Clinic and Spa LLC
• Sarah Ann Wright

• Optometrist in Raytown, MO
• Providers in Raytown, MO by specialty
• Optometrist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2010; 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.

Verify at the official NPI Registry.