Organization Active NPI

Wesley J. Anderson, O.D., P.C.

  • Optometrist
  • Amarillo, TX
National Provider Identifier
1578719183
Registry record updated Feb 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
6566TG Issued in TX
Legal business name
WESLEY J. ANDERSON, O.D., P.C.
Practice address
200 Westgate Pkwy Unit M
Amarillo, TX 79121-1100
Phone
(806) 355-3800
NPI assigned
Aug 14, 2008
Last updated
Feb 11, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2010

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

Authorized official

Name
Wesley J Anderson, O.D.NPI 1801997861
Title
Owner
Phone
(806) 355-3800

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
Optometrist 152W00000X 6566TG TX Primary

Addresses

Primary practice location

200 Westgate Pkwy Unit M
Amarillo, TX 79121-1100

Mailing address

200 Westgate Pkwy Unit M
Amarillo, TX 79121-1100
Phone (806) 355-3800

Other identifiers 1

IdentifierTypeStateIssuer
1801997861OtherTXINDIVIDUAL NPI NUMBER FOR WESLEY J. ANDERSON, O.D.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080915000246 TX Part B Supplier - Clinic/Group Practice 3173699246 Receives reassigned benefits from 4 practitioners
Practice locations: Amarillo, TX

National Provider Directory

National Provider Directory

Locations

200 Westgate Pkwy
Unit M
Amarillo, TX 79121
Phone (806) 355-2244

Practitioners & affiliated clinicians

Practitioners 6

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": "1218672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265846400000",
    "number": "1578719183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WESTGATE PKWY UNIT M",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791211100",
            "telephone_number": "806-355-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WESTGATE PKWY UNIT M",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791211100",
            "telephone_number": "806-355-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESLEY J. ANDERSON, O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-14",
        "last_updated": "2010-02-11",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "806-355-3800",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6566TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER FOR WESLEY J. ANDERSON, O.D.",
            "identifier": "1801997861",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; 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.