Individual provider Active NPI

Rasika Khatu Whitesell, O.D.

  • Optometrist
  • Wilmington, NC
National Provider Identifier
1750717336
Registry record updated Oct 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2354 Issued in NC
Practice address
3501 Oleander Dr Ste 7
Wilmington, NC 28403-0824
Phone
(910) 254-9292
NPI assigned
Sep 16, 2013
Last updated
Oct 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2354 NC Primary

Addresses

Primary practice location

3501 Oleander Dr Ste 7
Wilmington, NC 28403-0824

Mailing address

1345 Western Blvd
Ste 120B
Jacksonville, NC 28546-7627
Phone (910) 376-8229

Other practice location 1

1950 Old Gallows Rd
Suite 520
Vienna, VA 22182-3990
Phone (703) 847-8899

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20131121000813 NC Practitioner - Optometry 8224264296 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lane Optometry PLLCGroup PAC ID 7517100647, 5 clinicians

Practice addresses (Care Compare)

1345 Western Blvd
Suite 120B
Jacksonville, NC 28546-7627
Phone (910) 376-8229

8035 Market St
Wilmington, NC 28411-9385
Phone (910) 200-0635

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2354NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brad Hearn OD PA Optometrist CurrentSince Sep 23, 2020 Accepting new patients
Lane Optometry, PLLC Optometrist CurrentSince Oct 6, 2020 Accepting new patients
Port City Optometry, PLLC Optometrist CurrentSince Oct 15, 2022 Accepting new patients
Brad Hearn OD PA Optometrist CurrentSince Sep 23, 2020 Accepting new patients
Myeyedr Optometry of North Carolina PLLC Optometrist PastSince May 19, 2014 Accepting new patients

Locations

16150 US Highway 17
Ste A
Hampstead, NC 28443
Phone (910) 270-2800

16525 Birkdale Commons Pkwy
Ste 100
Huntersville, NC 28078
Phone (704) 896-3311

1345 Western Blvd
Ste 120B
Jacksonville, NC 28546
Phone (910) 376-8229

8035 Market St
Wilmington, NC 28411
Phone (910) 200-0635

Organizations & group practices 5

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": "1379289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603411200000",
    "number": "1750717336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1345 WESTERN BLVD",
            "address_2": "STE 120B",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285467627",
            "telephone_number": "910-376-8229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 OLEANDER DR STE 7",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284030824",
            "telephone_number": "910-254-9292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1950 Old Gallows Rd",
            "address_2": "Suite 520",
            "address_purpose": "LOCATION",
            "city": "Vienna",
            "state": "VA",
            "postal_code": "221823990",
            "country_code": "US",
            "telephone_number": "703-847-8899",
            "fax_number": "703-991-0514",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITESELL",
        "first_name": "RASIKA",
        "middle_name": "KHATU",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-16",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NC",
            "license": "2354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.