Individual provider Active NPI

William Kevin Wright, O.D.

  • Optometrist
  • Alton, IL
National Provider Identifier
1790894673
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Practice address
2865 Homer M Adams Pkwy
Alton, IL 62002-4856
Phone
(618) 465-1654
Fax
(618) 465-8652
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X T02601 MO
Optometrist 152W00000X IL Primary

Addresses

Primary practice location

2865 Homer M Adams Pkwy
Alton, IL 62002-4856

Mailing address

2865 Homer M Adams Pkwy
Alton, IL 62002-4856
Phone (618) 465-1654

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070419000203 IL Practitioner - Optometry 2860597804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pec Alton LLCGroup PAC ID 7416240130, 2 clinicians

Practice addresses (Care Compare)

2865 Homer Adams Pkwy
Alton, IL 62002-4856
Phone (618) 465-1654

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
T02601MOMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Pec Alton, LLC Optometrist CurrentSince Jun 30, 2016 Accepting new patients

Locations

2865 Homer M Adams Pkwy
Alton, IL 62002
Phone (618) 223-6281

4111 N Illinois St
Swansea, IL 62226
Phone (314) 983-9800

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208476800000",
    "number": "1790894673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 HOMER M ADAMS PKWY",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620024856",
            "telephone_number": "618-465-1654",
            "fax_number": "618-465-8652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2865 HOMER M ADAMS PKWY",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620024856",
            "telephone_number": "618-465-1654",
            "fax_number": "618-465-8652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRIGHT",
        "first_name": "WILLIAM",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2008-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MO",
            "license": "T02601",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

Verify at the official NPI Registry.