Glen Wiley, APRN, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95017368 Issued in CA

Practice address

11555 Potrero Rd
Banning, CA 92220-6946

Phone

(251) 849-4761

NPI assigned

May 7, 2021

Last updated

Jul 14, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Group practices

The Urgent Care Associates of Texas PLLCGroup PAC ID 1355665795, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• The Urgent Care Associates of Texas, PLLC

  • Emergency Medicine Physician
  • Magnolia, TX
  • NPI 1235539933
  Medicare reassignment Care Compare group NPD
• Riverside-San Bernardino County Indian Health, Inc.

  dba San Manuel Indian Health

  • Federally Qualified Health Center (FQHC)
  • Grand Terrace, CA
  • NPI 1174676670

  TX

  Medicare reassignment NPD
• Woodlands Lone Star Emergency Physicians Group, PLLC

  • Emergency Medicine Physician
  • Magnolia, TX
  • NPI 1679994941
  Medicare reassignment NPD
• Riverside-San Bernardino County Indian Health, Inc

  dba Santa Rosa Indian Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Mountain Center, CA
  • NPI 1366028086
  NPD
• Riverside-San Bernardino County Indian Health, Inc.

  • Federally Qualified Health Center (FQHC)
  • Grand Terrace, CA
  • NPI 1720178478
  NPD
• America's ER Site 001, LLC

  dba America's ER

  • Emergency Care Clinic/Center
  • Magnolia, TX
  • NPI 1467897447
  NPD (past)

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1154905982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1647 W PONDEROSA WAY",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "917847454",
            "telephone_number": "909-697-6769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11555 POTRERO RD",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922206946",
            "telephone_number": "251-849-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "GLEN",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-07",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1031197",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2025038559",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95017368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Kirk Welsh, D.O.
• Colleen Wendtland, CPED, CFOM
• Western Dental Services, Inc.
• Rachel Lacey Wheeler, MOTR/L
• David Andrew Wilamart, RPH
• Brittany Williams
• Cameo Williams
• John Gavin Williams, M.D
• Brigitte Yvonne Willis, M.D., PH.D.
• Carlene Willis, FNP-C

• Family Nurse Practitioner in Banning, CA
• Providers in Banning, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.

Verify at the official NPI Registry.