Roger Lewis Wilson, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

3318 Issued in OH

Practice address

7721 E Main St
Reynoldsburg, OH 43068-1211

Phone

(614) 861-0950

Fax

(614) 861-5665

NPI assigned

Oct 24, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279670400000",
    "number": "1851475297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7721 E MAIN ST",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430681211",
            "telephone_number": "614-861-0950",
            "fax_number": "614-861-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7721 E MAIN ST",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430681211",
            "telephone_number": "614-861-0950",
            "fax_number": "614-861-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ROGER",
        "middle_name": "LEWIS",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2010-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2200501",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PROVIDER ID",
            "identifier": "000000119534",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED ID",
            "identifier": "142757",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Monique Ranee Williams
• Terese Williams
• Tommie Williams
• Olivia Jebbeh Willie
• Amber Tanisha Wilson, CPHT
• Wendy Renee Wilson, LPN
• Ikea Windham, RN
• Windsong Senior Home Care, LLC
• Ebunoluwa B Wion, D.O.
• Hana Woldetsadik

• Optometrist in Reynoldsburg, OH
• Providers in Reynoldsburg, OH by specialty
• Optometrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.