Individual provider Active NPI

Lauren Brandt Wiley, PA-C

  • Physician Assistant
  • Delaware, OH
National Provider Identifier
1083914485
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.003135RX Issued in OH
Practice address
2295 W William St
Delaware, OH 43015-1361
Phone
(740) 615-0100
Fax
(740) 615-0101
NPI assigned
Nov 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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 TL1596 SC
Physician Assistant 363A00000X 50.003135RX OH Primary

Addresses

Primary practice location

2295 W William St
Delaware, OH 43015-1361

Mailing address

PO Box 7527
Dublin, OH 43017-0727

Other practice location 1

500 London Ave
Marysville, OH 43040-5512
Phone (937) 644-6115

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lwiley88971@direct.ohiohealth.com OhioHealth Physician Group, Inc.

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
I20121206000577 OH Practitioner - Physician Assistant 3274715420 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

2295 W William St
Delaware, OH 43015-1361
Phone (740) 615-0100

393 E Town St
Columbus, OH 43215-4799

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1596SCMDAthletic Trainer
50.003135RXOHMDPhysician Assistant
TL1596SCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Jun 1, 2024 Accepting new patients
Ohiohealth Corporation CurrentSince Jun 1, 2024 Accepting new patients
Marion Physician Billing LLC Past Accepting new patients
Galion Emergency Physicians Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients
Marion General Hospital Foundation, Inc. Past Accepting new patients

Locations

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

Dept L3652
Columbus, OH 43260

2295 W William St
Delaware, OH 43015
Phone (740) 615-0100

561 W Central Ave
Delaware, OH 43015
Phone (614) 566-9983

269 Portland Way S
Galion, OH 44833
Phone (419) 468-4841

1000 McKinley Park Dr
Marion, OH 43302
Phone (740) 383-8400

500 London Ave
Marysville, OH 43040
Phone (740) 420-8451

651 W Marion Rd
Mount Gilead, OH 43338
Phone (419) 946-5015

Organizations & group practices 10

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": "1288569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1083914485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 W WILLIAM ST",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "430151361",
            "telephone_number": "740-615-0100",
            "fax_number": "740-615-0101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 London Ave",
            "address_purpose": "LOCATION",
            "city": "Marysville",
            "state": "OH",
            "postal_code": "430405512",
            "country_code": "US",
            "telephone_number": "937-644-6115",
            "fax_number": "937-619-4150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILEY",
        "first_name": "LAUREN",
        "middle_name": "BRANDT",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-01",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "TL1596",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.003135RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lwiley88971@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group, Inc.",
            "address_1": "2295 W William St",
            "city": "Delaware",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430151361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Delaware, OH

Sources for this page

Verify at the official NPI Registry.