Individual provider Active NPI

Jason R Wiles, MD

  • Neonatal-Perinatal Medicine Physician
  • Evansville, IN
National Provider Identifier
1093988107
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
01073878A Issued in IN
Practice address
3700 Washington Ave
Evansville, IN 47714-0001
Phone
(812) 485-4000
NPI assigned
Apr 9, 2008
Last updated
May 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 01073878A IN
Neonatal-Perinatal Medicine Physician 2080N0001X 01073878A IN Primary

Addresses

Primary practice location

3700 Washington Ave
Evansville, IN 47714-0001

Mailing address

3700 Washington Ave
Evansville, IN 47714-0001

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jason.wiles.2@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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140703001879 IN Practitioner - Pediatric Medicine 3678747300 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01073878AINMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Vincent Pediatric Subspecialties Pediatrics Current Accepting new patients
St Mary's Medical Group, LLC Pediatrics CurrentSince May 1, 2016 Accepting new patients
Primary Physicians Network LLC Pediatrics Current Accepting new patients
St Mary's Medical Group, LLC CurrentSince May 1, 2016 Accepting new patients
St Vincent Pediatric Subspecialties Pediatrics CurrentSince Jul 1, 2020 Accepting new patients
Nationwide Children's Hospital Past Accepting new patients
Mount Carmel Health System Past Accepting new patients
Ohiohealth Corporation Past Accepting new patients

Locations

1400 Professional Blvd
Ste 210
Evansville, IN 47714

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

3700 Washington Ave
Ste 1100
Evansville, IN 47714
Phone (812) 469-8170

3700 Washington Ave
Ste 2100A
Evansville, IN 47714
Phone (812) 485-1894

3900 Washington Ave
Evansville, IN 47714
Phone (812) 485-7425

3900 Washington Ave
#100
Evansville, IN 47714
Phone (317) 871-0000

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

2001 W 86th St
Indianapolis, IN 46260
Phone (317) 338-3617

8081 Township Line Rd
Ste 203
Indianapolis, IN 46260
Phone (317) 415-7921

8111 Township Line Rd
Indianapolis, IN 46260
Phone (317) 415-7921

Interoperability endpoints

  • Direct secure messaging: jason.wiles.2@7598.direct.athenahealth.com
  • Direct secure messaging: jason.wiles.3@7598.direct.athenahealth.com

Organizations & group practices 8

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": "1207699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1093988107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 WASHINGTON AVE",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477140001",
            "telephone_number": "812-485-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILES",
        "first_name": "JASON",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-09",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01073878A",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "IN",
            "license": "01073878A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jason.wiles.2@7598.direct.athenahealth.com",
            "affiliation": "Y",
            "affiliationName": "St Mary's Medical Group, LLC",
            "address_1": "3700 Washington Ave",
            "city": "Evansville",
            "state": "IN",
            "country_code": "US",
            "postal_code": "477500001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.