Individual provider Active NPI

Laura Maurine Mosley, OD

  • Optometrist
  • Valdosta, GA
National Provider Identifier
1699320713
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT003184 Issued in GA
Practice address
2108 N Patterson St
Valdosta, GA 31602-2947
Phone
(229) 244-3000
Fax
(229) 244-1934
NPI assigned
Aug 6, 2019
Last updated
Jul 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT003184 GA Primary

Addresses

Primary practice location

2108 N Patterson St
Valdosta, GA 31602-2947

Mailing address

2108 N Patterson St
Valdosta, GA 31602-2947
Phone (229) 244-3000

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL Valdosta
Direct Messaging Address Direct@WilsonEyeCenterValdostaGA.CompulinkDirect.com Direct

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20190910003434 GA Practitioner - Optometry 0042549446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Steven M. Wilson, O.D., P.C.Group PAC ID 4789644857, 5 clinicians

Practice addresses (Care Compare)

2108 N Patterson St
Valdosta, GA 31602-2947
Phone (912) 244-3000

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OPT003184GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Steven M. Wilson, O.D., P.C. Optometrist CurrentSince Aug 6, 2019 Accepting new patients

Locations

2108 N Patterson St
Valdosta, GA 31602
Phone (229) 244-3000

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": "1565049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1699320713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022947",
            "telephone_number": "229-244-3000",
            "fax_number": "229-244-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 N PATTERSON ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316022947",
            "telephone_number": "229-244-3000",
            "fax_number": "229-244-1934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSLEY",
        "first_name": "LAURA",
        "middle_name": "MAURINE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-06",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT003184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Valdosta",
            "affiliation": "N",
            "endpointDescription": "Office",
            "address_1": "2108 N Patterson St",
            "city": "Valdosta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "316022947",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Direct@WilsonEyeCenterValdostaGA.CompulinkDirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2108 N Patterson St",
            "city": "Valdosta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "316022947",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Valdosta, GA

Sources for this page

Verify at the official NPI Registry.