Active NPI
James Mikeal Wohlgemuth, OD
- Corneal and Contact Management Optometrist
- Burleson, TX
National Provider Identifier
1710972054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Corneal and Contact Management Optometrist
- License
- 2080T
- Practice address
- 201 NW Renfro St
Burleson, TX 76028-4113 - Phone
- (817) 295-5601
- Fax
- (817) 295-1884
- NPI assigned
- Sep 13, 2005
- 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 |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | 2080T | TX | Primary |
Addresses
Primary practice location
201 NW Renfro St
Burleson, TX 76028-4113
Mailing address
PO Box 609
Burleson, TX 76097-0609
Phone (817) 295-5601
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00E31A | Other | TX | BCBS OF TEXAS |
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 |
|---|---|---|---|
| 2080T | TX | MD | Corneal and Contact Management Optometrist |
| 2080 | TX | MD | Radiology Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steven D Bresnahan | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126569600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204502400000",
"number": "1710972054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 609",
"city": "BURLESON",
"state": "TX",
"postal_code": "760970609",
"telephone_number": "817-295-5601",
"fax_number": "817-295-1884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 NW RENFRO ST",
"city": "BURLESON",
"state": "TX",
"postal_code": "760284113",
"telephone_number": "817-295-5601",
"fax_number": "817-295-1884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOHLGEMUTH",
"first_name": "JAMES",
"middle_name": "MIKEAL",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-13",
"last_updated": "2008-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "TX",
"license": "2080T",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TEXAS",
"identifier": "00E31A",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burleson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.