Active NPI
Emma Leonor Wheeler
- Athletic Trainer
- Rincon, GA
National Provider Identifier
1174123251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 1136 Blue Jay Rd
Rincon, GA 31326-4927 - Phone
- (912) 658-2486
- NPI assigned
- Oct 28, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Internal Medicine) Physician | 207RS0010X | 058844834 | GA | |
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
1136 Blue Jay Rd
Rincon, GA 31326-4927
Mailing address
1136 Blue Jay Rd
Rincon, GA 31326-4927
Phone (912) 658-2486
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 058844834 | Other | GA | DRIVER'S LICESNE |
Electronic endpoints 3
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | NA | ||
| CONNECT URL | NA | ||
| CONNECT URL | NA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 058844834 | GA | MD | Sports Medicine (Internal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1603843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642550400000",
"number": "1174123251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1136 BLUE JAY RD",
"city": "RINCON",
"state": "GA",
"postal_code": "313264927",
"telephone_number": "912-658-2486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1136 BLUE JAY RD",
"city": "RINCON",
"state": "GA",
"postal_code": "313264927",
"telephone_number": "912-658-2486"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHEELER",
"first_name": "EMMA",
"middle_name": "LEONOR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-28",
"last_updated": "2022-01-19",
"certification_date": "2022-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "207RS0010X",
"taxonomy_group": "",
"desc": "Internal Medicine, Sports Medicine",
"state": "GA",
"license": "058844834",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVER'S LICESNE",
"identifier": "058844834",
"state": "GA"
}
],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "NA",
"affiliation": "N",
"endpointDescription": "NA",
"address_1": "1136 Blue Jay Rd",
"city": "Rincon",
"state": "GA",
"country_code": "US",
"postal_code": "313264927",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "NA",
"affiliation": "N",
"endpointDescription": "NA",
"address_1": "1136 Blue Jay Rd",
"city": "Rincon",
"state": "GA",
"country_code": "US",
"postal_code": "313264927",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "NA",
"affiliation": "N",
"endpointDescription": "NA",
"address_1": "1136 Blue Jay Rd",
"city": "Rincon",
"state": "GA",
"country_code": "US",
"postal_code": "313264927",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Rincon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.