Individual provider Active NPI

Cade Malone Wilson, O.D.

  • Optometrist
  • Jonesboro, AR
National Provider Identifier
1992716286
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2540 Issued in AR
Practice address
2100 E Highland Dr Ste 100
Jonesboro, AR 72401-5383
Phone
(870) 972-6040
Fax
(870) 972-5337
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2540 AR Primary

Addresses

Primary practice location

2100 E Highland Dr Ste 100
Jonesboro, AR 72401-5383

Mailing address

2100 E Highland Dr Ste 100
Jonesboro, AR 72401-5383
Phone (870) 972-6040

Other identifiers 1

IdentifierTypeStateIssuer
152190722MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20031124000810 AR Practitioner - Optometry 3173427895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Eye Care and Optical LLCGroup PAC ID 7416053368, 5 clinicians

Practice addresses (Care Compare)

1000 Windover Rd
Suite C
Jonesboro, AR 72401-6067

1515 W Kingshighway
Unit 2
Paragould, AR 72450-4010
Phone (870) 215-0000

2100 E Highland Dr
Suite 100
Jonesboro, AR 72401-5144

2100 E Highland Dr
Suite 100
Jonesboro, AR 72401-6067
Phone (870) 972-6040

2100 Highland Dr
Suite 100
Jonesboro, AR 72401-6067

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery75

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2540ARMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Eye Care & Optical LLC Optometrist CurrentSince Jan 22, 2007 Accepting new patients

Locations

3000 E Highland Dr
Ste 609
Jonesboro, AR 72401
Phone (870) 336-9090

2100 E Highland Dr
Ste 100
Jonesboro, AR 72401
Phone (870) 336-9090

1000 Windover Rd
Ste C
Jonesboro, AR 72401
Phone (870) 972-6040

1515 W Kingshighway
Unit 2
Paragould, AR 72450
Phone (870) 215-0000

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.

NPI Registry JSON

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1992716286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 E HIGHLAND DR STE 100",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015383",
            "telephone_number": "870-972-6040",
            "fax_number": "870-972-5337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 E HIGHLAND DR STE 100",
            "city": "JONESBORO",
            "state": "AR",
            "postal_code": "724015383",
            "telephone_number": "870-972-6040",
            "fax_number": "870-972-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CADE",
        "middle_name": "MALONE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AR",
            "license": "2540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152190722",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jonesboro, AR

Sources for this page

Verify at the official NPI Registry.