Individual provider Active NPI

Leonard Wilkins, O.D.

  • Corneal and Contact Management Optometrist
  • Tahlequah, OK
National Provider Identifier
1689777468
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
815 Issued in OK
Practice address
209 Woodlawn Ave
Tahlequah, OK 74464-3317
Phone
(918) 456-0585
Fax
(918) 456-6232
NPI assigned
Sep 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 815 OK Primary

Addresses

Primary practice location

209 Woodlawn Ave
Tahlequah, OK 74464-3317

Mailing address

209 Woodlawn Ave
Tahlequah, OK 74464-3317
Phone (918) 456-0585

Other identifiers 5

IdentifierTypeStateIssuer
0676100001OtherDMERC/PIN
156833OtherFED NWO
100767470AMedicaidOK
5001OtherNEFN DISP
900243OtherOKOK. NWO

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

LicenseStateTypeSpecialty
815OKMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Leonard L. Wilkins O.D. Past Accepting new patients
Wilkerson Eye Care, PLLC PastSince Sep 23, 2024 Accepting new patients

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": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321228800000",
    "number": "1689777468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 WOODLAWN AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643317",
            "telephone_number": "918-456-0585",
            "fax_number": "918-456-6232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 WOODLAWN AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744643317",
            "telephone_number": "918-456-0585",
            "fax_number": "918-456-6232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "LEONARD",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2011-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "OK",
            "license": "815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC/PIN",
            "identifier": "0676100001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FED NWO",
            "identifier": "156833",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100767470A",
            "state": "OK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEFN DISP",
            "identifier": "5001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OK.  NWO",
            "identifier": "900243",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.