D E Wadsworth Jr OD LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

D E WADSWORTH JR OD LLC

Practice address

1936 N Perkins Rd
Stillwater, OK 74075-2978

Phone

(405) 543-1846

NPI assigned

Jan 15, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Darwin E Wadsworth Jr., ODNPI 1386784130

Title

Owner

Phone

(405) 543-1846

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OK

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Darwin E Wadsworth Jr., O.D.

  • Optometrist
  • Tulsa, OK
  • NPI 1386784130
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1610668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615939200000",
    "number": "1801485578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1936 N PERKINS RD",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740752978",
            "telephone_number": "405-543-1846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1936 N PERKINS RD",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740752978",
            "telephone_number": "405-543-1846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D E WADSWORTH JR OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-15",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A",
        "authorized_official_last_name": "WADSWORTH",
        "authorized_official_first_name": "DARWIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "405-543-1846",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100765550B",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Schuyler Lewis Cunningham
• Alex B Cuppawhe
• Jane L Curtis, MD
• Erin Lynn Cusack, M.S
• Angela Dawn Cushing, PA-C
• Nigel Aaron D'Souza, MS, LPC CANDIDATE
• Solange Dabone
• Aimee Dahlke, MA, CCC-SLP
• Alison Faith Dancer, M.D.
• Jack T Dancer I, M.D.

• Primary Care Clinic/Center in Stillwater, OK
• Providers in Stillwater, OK by specialty
• Primary Care Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.