Robert H Wilds, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1036 Issued in SC

Practice address

105 Wappoo Creek Drive
Suite 4B
Charleston, SC 29412-2169

Phone

(843) 795-7971

NPI assigned

Nov 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240185600000",
    "number": "1891867909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 WAPPOO CREEK DRIVE",
            "address_2": "SUITE 4B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294122169",
            "telephone_number": "843-795-7971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 WAPPOO CREEK DRIVE",
            "address_2": "SUITE 4B",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294122169",
            "telephone_number": "843-795-7971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDS",
        "first_name": "ROBERT",
        "middle_name": "H",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-14",
        "last_updated": "2009-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D10361",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Elizabeth Wilder, MD
• Rachel Ann Wildman Dellos, DNP APRN-CNP NNP-BC
• Jenna Kaye Wildman, M.D.
• Robert Boyd Wildman
• Chloe Wilds, LPC-A
• Suzanne Lynn Wilds, D.C.
• Wildstein Spine Center, PA
• Michael Scott Wildstein, MD
• Lindsay C Wiles, PT
• Maria Kathleen Wiley, MD

• Optometrist in Charleston, SC
• Providers in Charleston, SC by specialty
• Optometrist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.