Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Nicole Wilson, OD

Individual provider Optometrist · NPI 1154973220

Nicole Wilson, OD is an Optometry in Saint Peters, Missouri. Graduated from University of Missouri St Louis - School of Optometry in 2017, 9 years ago. Accepts Medicare assignment. Licensed in Illinois and Missouri.

Years since qualifying
9
Trained at
University of Missouri St Louis - School of Optometry
Licensed in
IL, MO
In the registry since
2019
Specialties on file
2
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

200 Costco Way
Saint Peters, MO 63376-4385
Phone: (636) 970-4007
Fax: (314) 269-0325
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence 2019019708 (MO)
Optometrist Taxonomy 152W00000X · Licence 046.011340L (IL)

Record details

NPI number1154973220
Entity typeIndividual (Type 1)
GenderFemale
Credentials OD
Sole proprietorNo
NPI enumeratedJuly 9, 2019
Last updated in NPPESMarch 8, 2022
Certification dateMarch 8, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolUNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
Graduated 2017 (9 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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