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Deactivated NPI 1164614210 Deactivated / Inactive NPI Male Practitioner

James Alan Wilson , OPTICAN

Technician/Technologist - Ocularist • Jacksonville Beach, FL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, James Wilson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date August 13, 2007
NPI Deactivation Date March 02, 2018
Total Practice Duration ~11 Years of Practice (2007 – 2018)

Professional Overview & Biography Verified Profile Summary

James Wilson, OPTICAN was a registered Technician/Technologist - Ocularist practicing in Jacksonville Beach, FL. Throughout an active medical career spanning 11 years, James Wilson provided care at the practice location at 21 12TH ST S until profile deactivation on 2018-03-02.

Practice Location & Contact Primary Location

Practice Address

21 12th St S

Jacksonville Beach, FL 322503433

Telephone 9042492166
Fax 9042462383
Associated Practice Facility / Clinic
🏢 Beach Optical Company Facility NPI 1902918535

Specialty Benchmarks & Practice Insights

Comparative analytics for Technician/Technologist - Ocularist in Jacksonville Beach, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
1 Specialists

Practicing in Jacksonville Beach, FL (8 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Technician/Technologist - Ocularist Primary Specialty

NUCC Taxonomy Code: 156FX1700X

State License FL DO745

An ocularist is a thoroughly trained professional skilled in the art of fitting, painting, and fabricating custom ocular prostheses. In addition to creating custom ocular prostheses, and providing long-term care through periodic examinations, an ocularist provides the patient with complete instructions on the care and maintenance of their prosthesis.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated March 02, 2018

Record deactivated on March 02, 2018

NPI Profile Active August 13, 2007

NPI status registered as active in NPPES database

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Updated Practice Location August 13, 2007

Registered at 21 12TH ST S, JACKSONVILLE BEACH, FL 322503433 (Tel: 9042492166)

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Updated Business Mailing Address August 13, 2007

Registered at PO BOX 16032, JACKSONVILLE, FL 322456032 (Tel: 9042492166)

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Provider Name / Credentials Updated August 13, 2007

Recorded as JAMES WILSON, OPTICAN

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 13, 2007

Technician/Technologist (License #DO745 in FL)

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Initial NPI Registration & Enumeration August 13, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1164614210
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 13, 2007
Last Update: August 13, 2007
Deactivation Date: March 02, 2018

Mailing Address

Po Box 16032

Jacksonville, FL 322456032

Phone: 9042492166

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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