Individual provider Active NPI

Micki M Wheeler, PA-C

  • Physician Assistant
  • Newburgh, IN
National Provider Identifier
1083814537
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10000965A Issued in IN
Practice address
100 St Marys Epworth Xing Ste B100
Newburgh, IN 47630-9497
Phone
(812) 469-8300
NPI assigned
Jul 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA656 KY
Physician Assistant 363A00000X 10000965A IN Primary

Addresses

Primary practice location

100 St Marys Epworth Xing Ste B100
Newburgh, IN 47630-9497

Mailing address

100 St Marys Epworth Xing Ste B100
Newburgh, IN 47630-9497

Other practice location 1

3700 Washington Ave
Ed
Evansville, IN 47750-0001
Phone (812) 485-7349

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address micki.wheeler.1@7598.direct.athenahealth.com St Mary's Medical Group, LLC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20071117000036 IN Practitioner - Physician Assistant 9032148606 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Marys Medical Group LLCGroup PAC ID 1153493341, 230 clinicians

Practice addresses (Care Compare)

100 St Marys Epworth Xing
Newburgh, IN 47630-9497
Phone (812) 469-8170

801 Saint Marys Dr
505E
Evansville, IN 47714-0528
Phone (812) 491-3236

Hospital & facility affiliations

  • Ascension St Vincent Evansville Hospital, Evansville, IN, CCN 150100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10000965AINMDPhysician Assistant
PA656KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Mary'S Medical Group, LLC Physician Assistant CurrentSince Sep 22, 2019 Accepting new patients
Emergency Medicine Physicians of Vanderburgh County, PC Past Accepting new patients
Audubon Gi PSC Past Accepting new patients

Locations

1116 Millis Ave
Boonville, IN 47601
Phone (812) 897-4800

801 Saint Marys Dr
Ste 505E
Evansville, IN 47714
Phone (812) 491-3236

3838 N 1st Ave
Ste E
Evansville, IN 47710
Phone (812) 425-3362

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

100 S Rosenberger Ave
Ste A100
Evansville, IN 47712
Phone (812) 433-2000

250 W 96th St
#520
Indianapolis, IN 46260
Phone (317) 583-3331

100 St Marys Epworth Xing
Ste B100
Newburgh, IN 47630
Phone (812) 469-8300

Interoperability endpoints

  • Direct secure messaging: micki.wheeler.1@7598.direct.athenahealth.com

Organizations & group practices 4

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1083814537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ST MARYS EPWORTH XING STE B100",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476309497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ST MARYS EPWORTH XING STE B100",
            "city": "NEWBURGH",
            "state": "IN",
            "postal_code": "476309497",
            "telephone_number": "812-469-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3700 Washington Ave",
            "address_2": "ED",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477500001",
            "country_code": "US",
            "telephone_number": "812-485-7349",
            "fax_number": "812-485-7344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "MICKI",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA656",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10000965A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "micki.wheeler.1@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "100 St Marys Epworth Xing Ste B100",
            "city": "Newburgh",
            "state": "IN",
            "country_code": "US",
            "postal_code": "476309497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newburgh, IN

Sources for this page

Verify at the official NPI Registry.