NPIMap

Individual provider Active NPI

Dandria T Wiley, NP

  • Family Nurse Practitioner
  • New Orleans, LA
National Provider Identifier
1083841712
Registry record updated Jun 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP05810 Issued in LA
Practice address
4018 Magazine St
New Orleans, LA 70115-2749
Phone
(504) 897-9200
Fax
(504) 897-9234
NPI assigned
Jun 20, 2009
Last updated
Jun 20, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2009

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 AP05810 LA Primary

Addresses

Primary practice location

4018 Magazine St
New Orleans, LA 70115-2749

Mailing address

182 Hannibal CT
Biloxi, MS 39530-3916
Phone (228) 324-9236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110112000762 MS Practitioner - Nurse Practitioner 1052500600 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians
Pascagoula Urgent CareGroup PAC ID 8527241207, 9 clinicians

Practice addresses (Care Compare)

1340 Broad Ave
Suite 440
Gulfport, MS 39501-2460
Phone (228) 867-4856

2210 Denny Ave
Pascagoula, MS 39567-3416
Phone (228) 372-6040

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP05810LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital at Gulfport Current Accepting new patients
Pascagoula Urgent Care CurrentSince Mar 1, 2012 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Nov 14, 2010 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients
David F. Roberts, MD Past Accepting new patients

Locations

1756 Popps Ferry Rd
Ste A
Biloxi, MS 39532
Phone (228) 865-3200

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

2210 Denny Ave
Pascagoula, MS 39567
Phone (228) 372-6040

Networks

  • LA PPO C-SNP

Interoperability endpoints

  • Direct secure messaging: dwiley@direct.mhg.com

Organizations & group practices 6

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.

Hospital & facility affiliations 63

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

View all 63

NPI Registry JSON

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

{
    "created_epoch": "1245456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245456000000",
    "number": "1083841712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "182 HANNIBAL CT",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395303916",
            "telephone_number": "228-324-9236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4018 MAGAZINE ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701152749",
            "telephone_number": "504-897-9200",
            "fax_number": "504-897-9234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "DANDRIA",
        "middle_name": "T",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-20",
        "last_updated": "2009-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP05810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.