Wildwood Eye Care LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

WILDWOOD EYE CARE LLC

Practice address

76 Bethel Drive
Dawsonville, GA 30534-9435

Phone

(706) 531-9900

NPI assigned

Jul 16, 2025

Organization subpart

No

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

Authorized official

Name

David Grosswald

Title

President

Phone

(770) 952-6412

Specialties & licenses 1

Addresses

Other names 1

• Dawson Vision Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Wildwood Eye Care LLC

  • Optometrist
  • Marietta, GA
  • NPI 1396073862

  O20100224000431

  Same enrollment

Tax ID family

Dawson Vision2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Wildwood Eye Care LLC

  • Optometrist
  • Marietta, GA
  • NPI 1396073862
  NPD tax ID

Practitioners 6

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

• Patrick Dicus, OD

  • Optometrist
  • Alpharetta, GA
  • NPI 1093494379
  NPD
• Stuart R Tasman, OD

  • Optometrist
  • Marietta, GA
  • NPI 1073548426
  NPD
• Karla Reece Thomason, O.D.

  • Optometrist
  • Dawsonville, GA
  • NPI 1598107682
  NPD
• Heather Zutaut, O.D.

  • Optometrist
  • Marietta, GA
  • NPI 1699709246
  NPD
• Megan V Mosley, OD

  • Optometrist
  • Bloomington, IL
  • NPI 1073848511
  NPD
• Mark S Dickinson, OD

  • Optometrist
  • Alpharetta, GA
  • NPI 1457430464
  NPD (past)

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

{
    "created_epoch": "1752624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1609768464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 BETHEL DRIVE",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305349435",
            "telephone_number": "706-531-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 BETHEL DRIVE",
            "city": "DAWSONVILLE",
            "state": "GA",
            "postal_code": "305349435",
            "telephone_number": "706-531-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDWOOD EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-07-16",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "GROSSWALD",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-952-6412"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dawson Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Whispering Willow
• James Paul Whitcomb, RPH
• Alec Whitley
• Ken Whitlow, PT
• Melissa Dora Wilcox, D.C.
• Madison Williams, FNP-C
• Sarah Williamson, PA
• Jenna Wilson, M.S., CCC-SLP
• Meagan Wilson, NP-C
• Daniel Scott Winter, OD

• Optometrist in Dawsonville, GA
• Providers in Dawsonville, GA by specialty
• Optometrist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; 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.