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Deactivated NPI 1629031240 Deactivated / Inactive NPI Male Practitioner

Michael L Wilson

Optometrist • Manistique, MI

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

Registration / Start Date April 07, 2006
NPI Deactivation Date October 16, 2024
Total Practice Duration ~18 Years of Practice (2006 – 2024)

Professional Overview & Biography Verified Profile Summary

Michael Wilson was a registered Optometrist practicing in Manistique, MI. Throughout an active medical career spanning 18 years, Michael Wilson provided care at the practice location at 101 WALNUT ST until profile deactivation on 2024-10-16.

Practice Location & Contact Primary Location

Practice Address

101 Walnut St

Manistique, MI 498541435

Telephone 9063415689
Fax 9063415723
Associated Practice Facility / Clinic
🏢 Michael Lyle Wilson Pc Facility NPI 1427220508

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Manistique, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 30.0 Yrs
State Avg: 21.1 Yrs
Regional Practice Density
2 Specialists

Practicing in Manistique, MI (2032 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

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License MI 02482

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

2 Associated Practitioners
Jakyser Lett

Social Worker

NPI 1043029390
Hope St. Amour , LLMSW

Social Worker - Clinical

NPI 1235052275

Limited Licensed Master Social Worker

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 October 16, 2024

Record deactivated on October 16, 2024

NPI Profile Active March 03, 2008

NPI status registered as active in NPPES database

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Updated Practice Location March 03, 2008

Registered at 101 WALNUT ST, MANISTIQUE, MI 498541435 (Tel: 9063415689)

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Updated Business Mailing Address March 03, 2008

Registered at 101 WALNUT ST, MANISTIQUE, MI 498541435 (Tel: 9063415689)

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Provider Name / Credentials Updated March 03, 2008

Recorded as MICHAEL WILSON

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Medical Taxonomy / Specialty Registered (Primary Specialty) March 03, 2008

Optometrist (License #02482 in MI)

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Initial NPI Registration & Enumeration April 07, 2006

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: 1629031240
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 07, 2006
Last Update: March 03, 2008
Deactivation Date: October 16, 2024

Mailing Address

101 Walnut St

Manistique, MI 498541435

Phone: 9063415689

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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