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Deactivated NPI 1912993544 Deactivated / Inactive NPI Female Practitioner

Dr. Robin Lynn Wilson , OD

Optometrist • Peoria, IL

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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, Dr. Robin Wilson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 20, 2005
NPI Deactivation Date March 23, 2006
Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Robin Wilson, OD was a registered Optometrist practicing in Peoria, IL. Throughout an active medical career spanning 1 years, Dr. Wilson provided care at the practice location at 4620 N UNIVERSITY ST until profile deactivation on 2006-03-23.

Historical Medicare Part B clinical services included photography of the retina. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

4620 N University St

Peoria, IL 616145889

Telephone 3096928222
Fax 3096928226
Associated Practice Facility / Clinic
🏢 J A K Enterprises Inc Facility NPI 1134173321

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Peoria, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 23.4 Yrs
State Avg: 22.8 Yrs
Regional Practice Density
43 Specialists

Practicing in Peoria, IL (2783 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
21.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2017)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
92250 Photography of the retina
11 11 $74.00 $57.99

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License IL 046007848

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
NPI 1639166226

Doctor of Optometry

Career & Practice History Timeline

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

11 Historical Events
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Updated Practice Location February 16, 2017

Registered at 4620 N UNIVERSITY ST, PEORIA, IL 616145889 (Tel: 3096928222)

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Updated Business Mailing Address February 16, 2017

Registered at 8309 N KNOXVILLE AVE, PEORIA, IL 616152170 (Tel: 3096939540)

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Provider Name / Credentials Updated February 16, 2017

Recorded as ROBIN WILSON, O.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 16, 2017

Optometrist (License #046007848 in IL)

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Updated Practice Location July 08, 2007

Registered at 2000 W PIONEER PKWY, SUITE 23, PEORIA, IL 616151835 (Tel: 3096903336)

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Updated Business Mailing Address July 08, 2007

Registered at 2000 W PIONEER PKWY, SUITE 23, PEORIA, IL 616151835 (Tel: 3096903336)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ROBIN WILSON, O.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Optometrist

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NPI Profile Reactivated March 29, 2006

Record officially reactivated for active practice on March 29, 2006

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NPI Profile Deactivated March 23, 2006

Record deactivated on March 23, 2006

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Initial NPI Registration & Enumeration September 20, 2005

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: 1912993544
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 20, 2005
Last Update: February 16, 2017
Deactivation Date: March 23, 2006
Sole Proprietor: No

Mailing Address

8309 N Knoxville Ave

Peoria, IL 616152170

Phone: 3096939540

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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