Jennifer Renee Wiles, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5005791 Issued in NC

Practice address

3673 Hillsborough Rd.
Durham, NC 27705

Phone

(866) 389-2727

NPI assigned

Feb 9, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Icem-Ball, LLC

  • Emergency Medicine Physician
  • Muncie, IN
  • NPI 1316273691
  NPD (past)

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

{
    "created_epoch": "1297209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402876800000",
    "number": "1104122134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 LORELEI CT",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277134495",
            "telephone_number": "919-578-4853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3673 HILLSBOROUGH RD.",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "27705",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILES",
        "first_name": "JENNIFER",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-09",
        "last_updated": "2014-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5005791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000704774",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201013390A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Yeager Wilder, MS, CCC-SLP
• Julius Middleton Wilder, MD/PHD
• Benjamin Marshall Wildman-Tobriner, M.D.
• Victoria Rae Wildman, PA-C
• Meredith Anne Wilds, CPNP-AC
• Leigh Anne Wilfley
• David Andrew Wilfret, M.D.
• Stephanie Wilhoit Reeves
• Sharon Anne Wilinski, PHARMD
• Aaron Joseph Wilke, MD

• Family Nurse Practitioner in Durham, NC
• Providers in Durham, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.