Individual provider Active NPI

Stephen Wiley, CNP

  • Family Nurse Practitioner
  • Upper Arlington, OH
National Provider Identifier
1073044327
Registry record updated Dec 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.020670 Issued in OH
Practice address
3924 Mountview Rd
Upper Arlington, OH 43220-4806
Phone
(614) 776-4379
NPI assigned
Mar 27, 2017
Last updated
Dec 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.020670 OH Primary

Addresses

Primary practice location

3924 Mountview Rd
Upper Arlington, OH 43220-4806

Mailing address

PO Box 21351
Columbus, OH 43221-0351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170607001698 OH Practitioner - Nurse Practitioner 3375811789 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthy AllianceGroup PAC ID 0749305308, 10 clinicians

Practice addresses (Care Compare)

4660 Trueman Blvd
Hilliard, OH 43026-2438
Phone (614) 771-4400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.020670OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healthy Alliance CurrentSince May 1, 2017 Accepting new patients

Locations

4660 Trueman Blvd
Hilliard, OH 43026
Phone (614) 771-4400

677 Cooper Rd
Westerville, OH 43081
Phone (614) 452-0500

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1490572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607472000000",
    "number": "1073044327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 21351",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432210351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3924 MOUNTVIEW RD",
            "city": "UPPER ARLINGTON",
            "state": "OH",
            "postal_code": "432204806",
            "telephone_number": "614-776-4379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "STEPHEN",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-27",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.020670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Arlington, OH

Sources for this page

Verify at the official NPI Registry.