Active NPI
Jon M Williamson, OD
- Optometrist
- Sparta, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 2115
- Practice address
- 1111 W Wisconsin St
Sparta, WI 54656-2233 - Phone
- (608) 269-6731
- NPI assigned
- Jun 15, 2005
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 2115 | WI | Primary |
Addresses
Primary practice location
1111 W Wisconsin St
Sparta, WI 54656-2233
Mailing address
1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 38584300 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- 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
- Illinois College of Optometry at Chicago, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1111 W Wisconsin St
Sparta, WI 54656-2233
Phone (608) 269-6731
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 20 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gundersen Lutheran Express Care, Inc | Current | Accepting new patients | |
| Gundersen Clinic LTD | Current | Accepting new patients | |
| Gundersen Clinic LTD | Current | Accepting new patients |
Locations
601 W Adams St
Blk River Fls, WI 54615
Phone (715) 274-6451
402 W Lake St
Friendship, WI 53934
Phone (608) 339-3331
1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102
1600 Main St
Onalaska, WI 54650
Phone (608) 783-4681
610 E Taylor St
Prairie du Chien, WI 53821
Phone (608) 326-6466
1111 W Wisconsin St
Sparta, WI 54656
Phone (608) 269-1588
400 Jefferson Ave
Sparta, WI 54656
Phone (608) 269-2132
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinic/Center
- La Crosse, WI
- NPI 1851343115
-
- Clinic/Center
- La Crosse, WI
- NPI 1043446974
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1932104114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1836 SOUTH AVE",
"city": "LA CROSSE",
"state": "WI",
"postal_code": "546015429",
"telephone_number": "608-782-7300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1111 W WISCONSIN ST",
"city": "SPARTA",
"state": "WI",
"postal_code": "546562233",
"telephone_number": "608-269-6731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMSON",
"first_name": "JON",
"middle_name": "M",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-15",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "2115",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "38584300",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sparta, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.