Active NPI
Amanda S Wiles, NP-C
- Occupational Health Nurse Practitioner
- Jamestown, ND
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Health Nurse Practitioner
- License
- R39620
- Practice address
- 904 5TH Ave NE
Jamestown, ND 58401-3437 - Phone
- (701) 253-4000
- NPI assigned
- Jan 17, 2013
- Last updated
- Oct 2, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2013001306 | MO | |
| Nurse Practitioner | 363L00000X | R39620 | ND | |
| Occupational Health Nurse Practitioner | 363LX0106X | R39620 | ND | Primary |
Addresses
Primary practice location
904 5TH Ave NE
Jamestown, ND 58401-3437
Mailing address
PO Box 2168
Fargo, ND 58107-2168
Phone (701) 234-2119
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 84313 | Medicaid | ND |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
401 N 9TH St
Bismarck, ND 58501-4530
Phone (701) 712-4500
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.63 of 100
- Quality
- 89.39
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.04
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Innovis Health LLC | Current | Accepting new patients | |
| Innovis Health, LLC | Current | Accepting new patients | |
| Innovis Health LLC | Current | Accepting new patients |
Locations
401 N 9th St
Bismarck, ND 58501
Phone (701) 530-6000
3000 32nd Ave S
Fargo, ND 58103
Phone (701) 364-3000
2430 20th St SW
Jamestown, ND 58401
Phone (701) 253-5300
Organizations & group practices 3
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.
-
dba Essentia Health-Osgood Clinic
- Multi-Specialty Clinic/Center
- Fargo, ND
- NPI 1144776576
-
dba Essentia Health-North Fargo Clinic
- Occupational Medicine Clinic/Center
- Fargo, ND
- NPI 1568918902
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba CHI St. Alexius Health
- General Acute Care Hospital
- Bismarck, ND
- NPI 1306832654
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1358380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727827200000",
"number": "1144568767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2168",
"city": "FARGO",
"state": "ND",
"postal_code": "581072168",
"telephone_number": "701-234-2119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "904 5TH AVE NE",
"city": "JAMESTOWN",
"state": "ND",
"postal_code": "584013437",
"telephone_number": "701-253-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILES",
"first_name": "AMANDA",
"middle_name": "S",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-17",
"last_updated": "2024-10-02",
"certification_date": "2024-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MO",
"license": "2013001306",
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "ND",
"license": "R39620",
"primary": false
},
{
"code": "363LX0106X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Occupational Health",
"state": "ND",
"license": "R39620",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "84313",
"state": "ND"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jamestown, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.