Ryan Widdison, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2066 Issued in AZ

Practice address

1925 Florence Ave
Kingman, AZ 86401-4617

Phone

(928) 753-2106

Fax

(928) 753-4283

NPI assigned

Jul 1, 2015

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

Enrolled in AZ

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

Specialty

Optometry

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mohave Eye Centers LTD.Group PAC ID 7911985247, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

90.73 of 100Reported as individual

Quality

81.46

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mohave Eye Centers LTD

  • Optometrist
  • Kingman, AZ
  • NPI 1063438257
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435708800000",
    "number": "1639552169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 FLORENCE AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864014617",
            "telephone_number": "928-753-2106",
            "fax_number": "928-753-4283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 FLORENCE AVE",
            "city": "KINGMAN",
            "state": "AZ",
            "postal_code": "864014617",
            "telephone_number": "928-753-2106",
            "fax_number": "928-753-4283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIDDISON",
        "first_name": "RYAN",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-01",
        "last_updated": "2015-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "2066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• West Transportation LLC (yellow & lightning taxi)
• Westside Behavioral Health LLC
• White Cliffs Counseling PLLC
• Jill A White, M.S. CCC-SLP
• Renee L White, LCSW
• William Wilkins, D.C.
• Jeri Wilhite Williams, ALHM
• Linda Phan Williams, PHARM.D.
• Paul Eugene Williams Jr., DDS
• Christian Chase Wilson, MD, MBA

• Optometrist in Kingman, AZ
• Providers in Kingman, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2015; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.