Dallin Wilson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

10408308-9934 Issued in UT

Practice address

2276 E Riverside Dr
St George, UT 84790-2636

Phone

(435) 773-5938

NPI assigned

May 17, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Midwestern University, Chicago College of Osteopathic Med, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Utah Community Health CenterGroup PAC ID 5799692398, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Southwest Utah Community Health Center

  dba Family Healthcare

  • Federally Qualified Health Center (FQHC)
  • St George, UT
  • NPI 1659358687
  Medicare reassignment Care Compare group NPD
• Wilson and Smith LLC

  dba Black Rock Eye Care

  • Optometrist
  • St George, UT
  • NPI 1548094246
  Medicare reassignment NPD Authorized official
• Southwest Utah Community Health Center

  dba Family Healthcare

  • Federally Qualified Health Center (FQHC)
  • Springdale, UT
  • NPI 1275314528
  NPD
• Southwest Utah Community Health Center

  dba Family Healthcare

  • Federally Qualified Health Center (FQHC)
  • Hurricane, UT
  • NPI 1780090944
  NPD (past)

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1790212173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 S 100 E",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847703925",
            "telephone_number": "435-773-5938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2276 E RIVERSIDE DR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847902636",
            "telephone_number": "435-773-5938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DALLIN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-17",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "UT",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "UT",
            "license": "10408308-9934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kiarah Wilmsen
• Wilson and Smith LLC (Black Rock Eye Care)
• Addilyn Wilson
• Andrew Wilson
• Chloe Wilson
• Don Benjamin Wilson, PHARM D
• Erik J. Wilson, DO
• Isaac Wilson
• Kylee Cody Wilson
• Marina Wilson

• Optometrist in St George, UT
• Providers in St George, UT by specialty
• Optometrist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; 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.