Joseph Devan Wilson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

3352 - 35 Issued in WI

Practice address

2229 S Memorial PL
Sheboygan, WI 53081-3715

Phone

(920) 458-9301

NPI assigned

Sep 27, 2011

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 WI

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Luxottica of America Inc

  dba Lenscrafters #287

  • Eyewear Supplier
  • Appleton, WI
  • NPI 1174622583
  Medicare reassignment

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405296000000",
    "number": "1669755591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1012 FALLS PARC DR",
            "address_2": "APARTMENT 15",
            "city": "SHEBOYGAN FALLS",
            "state": "WI",
            "postal_code": "530853370",
            "telephone_number": "360-317-6495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2229 S MEMORIAL PL",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813715",
            "telephone_number": "920-458-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JOSEPH",
        "middle_name": "DEVAN",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-27",
        "last_updated": "2014-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WI",
            "license": "3352 - 35",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willowglen Academy - Wilson
• Willowglen Academy-Wisconsin, Inc. (Howard Jansen Learning Center)
• Matthew Reed Willsey, D.O.
• Casey S Wilson, D.D.S.
• Christa Wilson, PHARMD
• Michelle L Wilson, APNP
• Amy Nicole Wimmer, DPT, PT
• Elizabeth Wimmler
• Wineland Family Eyecare LLC
• Kristine Wineland, APNP

• Optometrist in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Optometrist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.