Individual provider Active NPI

Michael Aaron Wheeler, O.D.

  • Low Vision Rehabilitation Optometrist
  • Mountain Home, AR
National Provider Identifier
1720135015
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Low Vision Rehabilitation OptometristTaxonomy code 152WL0500X
License
2558 Issued in AR
Practice address
360 Highway 5 N
Mountain Home, AR 72653-3039
Phone
(870) 425-2277
Fax
(870) 425-2021
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Low Vision Rehabilitation Optometrist 152WL0500X 2558 AR Primary
Low Vision Rehabilitation Optometrist 152WL0500X 2005020771 MO

Addresses

Primary practice location

360 Highway 5 N
Mountain Home, AR 72653-3039

Mailing address

102 Spring St
Melbourne, AR 72556-9241
Phone (870) 368-7921

Other identifiers 1

IdentifierTypeStateIssuer
159563722MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20080516000427 MO Practitioner - Optometry 1759307820 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Oct 23, 2023 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Oct 23, 2023 Accepting new patients
Ozark Eye Center, PA Low Vision Rehabilitation Past Accepting new patients
Roger Totten OD PA PastSince Apr 6, 2015 Accepting new patients

Locations

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

Organizations & group practices 4

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": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1720135015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 SPRING ST",
            "city": "MELBOURNE",
            "state": "AR",
            "postal_code": "725569241",
            "telephone_number": "870-368-7921",
            "fax_number": "870-368-7789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 HIGHWAY 5 N",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726533039",
            "telephone_number": "870-425-2277",
            "fax_number": "870-425-2021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "MICHAEL",
        "middle_name": "AARON",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "AR",
            "license": "2558",
            "primary": true
        },
        {
            "code": "152WL0500X",
            "taxonomy_group": "",
            "desc": "Optometrist, Low Vision Rehabilitation",
            "state": "MO",
            "license": "2005020771",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159563722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, AR

Sources for this page

Verify at the official NPI Registry.