Devin Richard Wieseckel, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPT003013 Issued in GA

Practice address

4280 E West Connector SE
Smyrna, GA 30082-4804

Phone

(770) 435-4457

Fax

(770) 435-4555

NPI assigned

Jun 24, 2017

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 GA

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Smyrna Eye Group, P.C.Group PAC ID 2163403510, 4 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

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 and National Provider Directory roles.

• Smyrna Eye Group, P.C.

  • Optometrist
  • Smyrna, GA
  • NPI 1124199534
  Medicare reassignment Care Compare group NPD
• Star Optometry Ga LLC

  • Optometrist
  • Cumming, GA
  • NPI 1528944451
  Medicare reassignment

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

{
    "created_epoch": "1498262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1649790262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4280 E WEST CONNECTOR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300824804",
            "telephone_number": "770-435-4457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 E WEST CONNECTOR SE",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300824804",
            "telephone_number": "770-435-4457",
            "fax_number": "770-435-4555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIESECKEL",
        "first_name": "DEVIN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica White
• Lindsey White
• Rakilly Whitehouse, LMSW
• Whole and Healthy Youth, LLC
• Whole Health Advocates
• Dorothy P. Wiggins, M.D.
• Susan F. Wilborn-Hood, DDS
• Christopher H Wilkin, D.M.D.
• Brenda Williams
• Cecelia L. Williams, PSY.D., MSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.