Timothy Wiseth, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

030.0133917 Issued in VT

Practice address

163 Veterans Dr Eye Clinic
White River Junction, VT 05009-0001

Phone

(320) 309-1016

NPI assigned

May 22, 2020

Last updated

May 22, 2020By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590105600000",
    "number": "1568085744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 11TH ST SW",
            "city": "LITTLE FALLS",
            "state": "MN",
            "postal_code": "563451917",
            "telephone_number": "320-309-1016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 VETERANS DR EYE CLINIC",
            "city": "WHITE RIVER JUNCTION",
            "state": "VT",
            "postal_code": "050090001",
            "telephone_number": "320-309-1016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISETH",
        "first_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-05-22",
        "last_updated": "2020-05-22",
        "certification_date": "2020-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VT",
            "license": "030.0133917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Briana Lee White, DNP, RN
• Robert White, RPH
• Caroline Elizabeth Whittington, DPM
• Katie Willard, CCC-SLP
• David Eldon Wilson III, RN
• Tarah Jessica Woolgar
• Richard William Wren, PH.D.
• Heather Wright, D.O.
• Mark E Young, D.D.S
• Mary Elizabeth Young, ARNP

• Optometrist in White River Junction, VT
• Providers in White River Junction, VT by specialty
• Optometrist in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.