Active NPI
Diane G Wilson, O.D.
- Optometrist
- Arnold, MO
National Provider Identifier
1841236635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- T02765
- Practice address
- 1235 Water Tower PL
Arnold, MO 63010-2142 - Phone
- (636) 296-8612
- Fax
- (636) 296-8055
- NPI assigned
- Jun 21, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | T02765 | MO | Primary |
| Vision Therapy Optometrist | 152WV0400X | T02765 | MO | |
| Pediatric Optometrist | 152WP0200X | T02765 | MO |
Addresses
Primary practice location
1235 Water Tower PL
Arnold, MO 63010-2142
Mailing address
7 Huntleigh Woods
Barnhart, MO 63012-1349
Phone (636) 296-8612
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 108374 | Other | MO | BLUE CROSS/BLUE SHIELD |
| 22-02076 | Other | MO | UNITED HEALTHCARE |
| 401231 | Other | MO | GROUP HEALTH PLAN |
| 20717 | Other | MO | BLUE CHOICE |
Other names 1
- Dr. Diane G Werkmeister
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- University of Missouri St Louis - School of Optometry, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1235 Water Tower PL
Arnold, MO 63010-2142
Phone (636) 296-8612
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 24 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T02765 | MO | MD | Pediatric Optometrist |
Interoperability endpoints
- direct@arnoldeyecenterarnoldmo.compulinkdirect.com
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.
-
- Optometrist
- Arnold, MO
- NPI 1770619637
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229904000000",
"number": "1841236635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 HUNTLEIGH WOODS",
"city": "BARNHART",
"state": "MO",
"postal_code": "630121349",
"telephone_number": "636-296-8612",
"fax_number": "636-296-8055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1235 WATER TOWER PL",
"city": "ARNOLD",
"state": "MO",
"postal_code": "630102142",
"telephone_number": "636-296-8612",
"fax_number": "636-296-8055"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "DIANE",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-21",
"last_updated": "2008-12-22",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "MO",
"license": "T02765",
"primary": true
},
{
"code": "152WV0400X",
"taxonomy_group": "",
"desc": "Optometrist, Vision Therapy",
"state": "MO",
"license": "T02765",
"primary": false
},
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "MO",
"license": "T02765",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "108374",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "22-02076",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUP HEALTH PLAN",
"identifier": "401231",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHOICE",
"identifier": "20717",
"state": "MO"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "DIANE",
"last_name": "WERKMEISTER",
"middle_name": "G",
"prefix": "DR.",
"credential": "O.D.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Arnold, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2008; 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.