Individual provider Active NPI

Emily Che Wilson, OD

  • Optometrist
  • Cullman, AL
National Provider Identifier
1679501233
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
S-A13-TA-594 Issued in AL
Practice address
601B Graham St SW
Cullman, AL 35055-5298
Phone
(205) 734-8514
Fax
(256) 734-8392
NPI assigned
Jun 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S-A13-TA-594 AL Primary

Addresses

Primary practice location

601B Graham St SW
Cullman, AL 35055-5298

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970

Other names 1

  • Emily Che Flores Former name

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20060315000019 AL Practitioner - Optometry 1557378619 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Alabama LLCGroup PAC ID 0840559878, 30 clinicians

Practice addresses (Care Compare)

601 B Graham St SW
Cullman, AL 35055-5298
Phone (256) 734-8514

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S-A13-TA-594ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Alabama LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Alabama, LLC Optometrist CurrentSince Aug 19, 2019 Accepting new patients

Locations

3431 Colonnade Pkwy
Ste 100
Birmingham, AL 35243
Phone (205) 967-2020

601B Graham St SW
Cullman, AL 35055
Phone (256) 734-8514

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1679501233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601B GRAHAM ST SW",
            "city": "CULLMAN",
            "state": "AL",
            "postal_code": "350555298",
            "telephone_number": "205-734-8514",
            "fax_number": "256-734-8392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "EMILY",
        "middle_name": "CHE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-30",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-A13-TA-594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "FLORES",
            "middle_name": "CHE",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cullman, AL

Sources for this page

Verify at the official NPI Registry.