Nicholas Whitesides, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046.012058 Issued in IL

Practice address

815 Lincoln Hwy
Fairview Heights, IL 62208-2230

Phone

(618) 628-8868

NPI assigned

Dec 2, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Optometry

Education

University of Missouri St Louis - School of Optometry, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Affordable Eyecare LLC

  • Optometrist
  • Fairview Heights, IL
  • NPI 1831980127
  Medicare reassignment NPD
• New Venture Pharmacy

  • Community/Retail Pharmacy
  • Fairview Heights, IL
  • NPI 1801957444
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1764633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764633600000",
    "number": "1740142322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 LINCOLN HWY",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 LINCOLN HWY",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082230",
            "telephone_number": "618-628-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITESIDES",
        "first_name": "NICHOLAS",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-12-02",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.012058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wellnessone of Fairview Heights, LLC
• Amy Michele Welser, BS
• Cayla Denise Wester, FNP
• Barbara Jean Whitaker, DNP, MPH, RN
• Dianne C Whitehead, LCSW
• Shawn T Wilcox
• Carlee Rae Williamson
• Maria Noel Wolf, CRNA
• Marissa Womble, RBT
• Anita J. Wood, O.D.

• Optometrist in Fairview Heights, IL
• Providers in Fairview Heights, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.