Jennifer M Wilson, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046010759 Issued in IL

Practice address

1009 N Cummings LN
Washington, IL 61571-9646

Phone

(309) 670-2020

Fax

(309) 444-7863

NPI assigned

Sep 21, 2012

Last updated

Aug 24, 2022By the provider in NPPES

Sex

Female

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 1

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vision Care Center PCGroup PAC ID 0042282691, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97 of 100Reported as group

Quality

94

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Vision Care Center PC

  • Optometrist
  • Peoria, IL
  • NPI 1043291677
  Medicare reassignment Care Compare group NPD
• Tina R Thomas OD LTD

  dba Thomas Eye Care

  • Optometrist
  • Washington, IL
  • NPI 1629398144
  NPD (past)
• Ted a McElroy OD, PC

  dba Vision Source Tifton

  • Optometrist
  • Tifton, GA
  • NPI 1578630794
  NPD (past)

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

{
    "created_epoch": "1348185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661299200000",
    "number": "1942551619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 N CUMMINGS LN",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615719646",
            "telephone_number": "309-670-2020",
            "fax_number": "309-693-9754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 N CUMMINGS LN",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615719646",
            "telephone_number": "309-670-2020",
            "fax_number": "309-444-7863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-21",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "046010759",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Washington Volunteer Fire Department and Rescue Squad Inc
• Kelly L Watkins, SPEECH LANG PATH
• Lily Watts
• Kristy Lyn Wheeler, BCBA, NCSP
• Theresa A Wiese, LCSW
• Jill Wirth-Rissman, MD
• Wolf Larson Enterprises LLC
• Carrie Marie Woodward, RN
• Christopher S Wright
• Wyman Sicher Eye Associates SC (Illinois Eye Center)

• Optometrist in Washington, IL
• Providers in Washington, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.

Verify at the official NPI Registry.