Active NPI
Robert Eugene Wooley, OD
- Optometrist
- Pana, IL
National Provider Identifier
1689737553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Practice address
- 104 S Oak
Suite a
Pana, IL 62557-1436 - Phone
- (217) 562-2512
- Fax
- (217) 562-2503
- NPI assigned
- Dec 19, 2006
- Last updated
- Mar 24, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | IL | Primary |
Addresses
Primary practice location
104 S Oak
Suite a
Pana, IL 62557-1436
Mailing address
PO Box 228
Pana, IL 62557-1436
Phone (217) 562-2512
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0520540001 | Other | IL | DME PROVIDER NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046006251 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DRS. Sehy and Jones Optometrists P.C. | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1206316800000",
"number": "1689737553",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 228",
"city": "PANA",
"state": "IL",
"postal_code": "625571436",
"telephone_number": "217-562-2512",
"fax_number": "217-562-2503"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 S OAK",
"address_2": "SUITE A",
"city": "PANA",
"state": "IL",
"postal_code": "625571436",
"telephone_number": "217-562-2512",
"fax_number": "217-562-2503"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOLEY",
"first_name": "ROBERT",
"middle_name": "EUGENE",
"name_prefix": "Mr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-19",
"last_updated": "2008-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DME PROVIDER NUMBER",
"identifier": "0520540001",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pana, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.