Individual provider Active NPI

Floyd Wilks Jr., MD

  • Surgery Physician
  • Lake Havasu City, AZ
National Provider Identifier
1124580030
Registry record updated Jun 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
76349 Issued in AZ
Practice address
1851 Mesquite Ave Ste 210
Lake Havasu City, AZ 86403-5681
Phone
(928) 854-7540
Fax
(928) 854-2405
NPI assigned
Apr 1, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Surgery Physician 208600000X 76349 AZ Primary

Addresses

Primary practice location

1851 Mesquite Ave Ste 210
Lake Havasu City, AZ 86403-5681

Mailing address

657 Island Dr
Lake Havasu City, AZ 86403-6943
Phone (407) 538-9250

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20250709002868 AZ Practitioner - General Surgery 3678087863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
HRMC, LLCGroup PAC ID 3072641265, 33 clinicians

Practice addresses (Care Compare)

1851 Mesquite Ave
Suite 210
Lake Havasu City, AZ 86403-5681
Phone (928) 854-7540

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy13
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76349AZMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
HRMC, LLC Current Accepting new patients
HRMC, LLC CurrentSince Jul 1, 2025 Accepting new patients
HRMC, LLC Family Medicine CurrentSince Jul 1, 2025 Accepting new patients
HRMC, LLC Past Accepting new patients

Locations

101 Civic Center Ln
Lk Havasu Cty, AZ 86403
Phone (928) 453-0150

1851 Mesquite Ave
Ste 210
Lk Havasu Cty, AZ 86403
Phone (928) 854-7540

Interoperability endpoints

  • Direct secure messaging: floyd.wilks.1@19231.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/19231/brand/1/csg/1/fhir/r4

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 2

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": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750377600000",
    "number": "1124580030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 ISLAND DR",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036943",
            "telephone_number": "407-538-9250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1851 MESQUITE AVE STE 210",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864035681",
            "telephone_number": "928-854-7540",
            "fax_number": "928-854-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKS",
        "first_name": "FLOYD",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-01",
        "last_updated": "2025-06-20",
        "certification_date": "2025-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "76349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.