Brooks Wiley, FPMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

8311379-4405 Issued in UT

Practice address

230 N 1680 E Ste H1
St George, UT 84790

Phone

(435) 652-1897

NPI assigned

Jun 22, 2016

Last updated

May 29, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Mr. Chanley Brooks Wiley Other name

Medicare fee-for-service enrollment

Enrolled in NV, UT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

St. George Children and Family Psychiatric Center PCGroup PAC ID 5294906855, 13 clinicians

Bergdale and Hall LLCGroup PAC ID 5698076602, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St. George Children & Family Psychiatric Center PC

  • Specialist
  • St George, UT
  • NPI 1225326044
  Medicare reassignment Care Compare group NPD
• Bergdale & Hall, LLC

  dba Serenity Counseling and Support Services

  • Clinical Social Worker
  • Las Vegas, NV
  • NPI 1972814630
  Medicare reassignment Care Compare group NPD
• Bergdale & Hall, LLC

  • Child & Adolescent Psychiatry Physician
  • Las Vegas, NV
  • NPI 1346609203
  NPD
• Center for Couples & Families

  dba Ascend Counseling and Wellness

  • Marriage & Family Therapist
  • St George, UT
  • NPI 1306364302
  NPD (past)
• Center for Couples & Families

  dba A Southern Utah Counseling Experience

  • Marriage & Family Therapist
  • St George, UT
  • NPI 1982898094
  NPD (past)

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

{
    "created_epoch": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527552000000",
    "number": "1003267923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 N 1680 E STE H1",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847902584",
            "telephone_number": "435-652-1897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N 1680 E STE H1",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "84790",
            "telephone_number": "435-652-1897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3111 S Valley View Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891028317",
            "country_code": "US",
            "telephone_number": "702-951-9751",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6879 W Charleston Blvd Ste A",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891171672",
            "country_code": "US",
            "telephone_number": "702-608-4220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3021 W Horizon Ridge Pkwy",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "NV",
            "postal_code": "890523990",
            "country_code": "US",
            "telephone_number": "702-919-6182",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6871 W Charleston Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891171600",
            "country_code": "US",
            "telephone_number": "702-489-2117",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "433 S Diamond Ranch Pkwy W",
            "address_purpose": "LOCATION",
            "city": "Hurricane",
            "state": "UT",
            "postal_code": "847373020",
            "country_code": "US",
            "telephone_number": "435-680-1610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILEY",
        "first_name": "BROOKS",
        "name_prefix": "Mr.",
        "credential": "FPMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-22",
        "last_updated": "2018-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NV",
            "license": "APRN002314",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "8311379-4405",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NV",
            "license": "APRN002314",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "8311379-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHANLEY",
            "last_name": "WILEY",
            "middle_name": "BROOKS",
            "prefix": "MR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mariah Wichael
• Bobbee Wiedeman
• Abigail Emma Wight
• Lakeatra Wilborn
• Sydney Wilde
• Corey Mack Wilhelmsen, D.C.
• Taylor J Wilkes
• Daniel Wilkinson, MD
• Richelle Wilkinson
• Maklayne Lorne Wilks

• Psychiatric/Mental Health Nurse Practitioner in St George, UT
• Providers in St George, UT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.