NPIMap

Individual provider Active NPI

Tracey Elizabeth Wiley, CRNP

  • Nurse Practitioner
  • Chambersburg, PA
National Provider Identifier
1194785162
Registry record updated Apr 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
TP005855B Issued in PA
Practice address
12 St Paul Dr Ste 210
Chambersburg, PA 17201-1035
Phone
(717) 217-6820
Fax
(717) 217-6942
NPI assigned
Mar 24, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 12

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 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellspan Medical Group 2,438 clinicians

Practice addresses (Care Compare)

12 St Paul Dr
Chambersburg, PA 17201-1035

25 Monument Rd
York, PA 17403-5073

2618 E Market St
Autumn House
York, PA 17403
Phone (717) 845-7214

354 Alexander Spring Rd
Carlisle, PA 17015-7451
Phone (717) 267-6427

914 W Market St
Autumn House West
York, PA 17403
Phone (717) 845-7214

Hospital & facility affiliations

  • Wellspan Chambersburg Hospital Hospital, Chambersburg, PA, CCN 390151
  • Wellspan Waynesboro Hospital Hospital, Waynesboro, PA, CCN 390138
  • Gettysburg Hospital Hospital, Gettysburg, PA, CCN 390065
  • Penn Highlands Huntingdon Hospital, Huntingdon, PA, CCN 390056
  • Upmc Carlisle Hospital, Carlisle, PA, CCN 390058

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040419001297 PA Practitioner - Nurse Practitioner 9335134279 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
TP005855BPAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellspan Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Wellspan Medical Group CurrentSince Jan 1, 2024 Accepting new patients
Wellspan Medical Group Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

354 Alexander Spring Rd
Ste 3
Carlisle, PA 17015
Phone (717) 217-6820

12 St Paul Dr
Ste 210
Chambersburg, PA 17201
Phone (717) 217-6820

24 Antrim Commons Dr
Greencastle, PA 17225
Phone (717) 593-0512

501 E Main St
Waynesboro, PA 17268
Phone (717) 765-3400

601 E Main St
Waynesboro, PA 17268
Phone (717) 765-5085

25 Monument Rd
Ste 270
York, PA 17403
Phone (717) 741-8250

601 Memory Ln
York, PA 17402
Phone (717) 851-6670

1600 S George St
York, PA 17403
Phone (717) 848-3615

Interoperability endpoints

  • Direct secure messaging: twiley226784@wellspan.direct-ci.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X TP005855B PA Primary

Addresses

NPPES NPI Registry

Primary practice location

12 St Paul Dr Ste 210
Chambersburg, PA 17201-1035

Mailing address

785 5TH Avenue
Suite 3
Chambersburg, PA 17201-4232
Phone (717) 263-9555

Other practice location 1

24 Antrim Commons Dr
Greencastle, PA 17225-1623
Phone (717) 217-6820

Other practice location 2

354 Alexander Spring Rd Ste 3
Carlisle, PA 17015-7451
Phone (717) 217-6820

Other practice location 3

601 E Main St
Waynesboro, PA 17268-2332
Phone (717) 217-6820

Other identifiers 7

NPPES NPI Registry
IdentifierTypeStateIssuer
102556669MedicaidPA
TP005855BOtherPALICENSE
867633OtherPAMEDICARE GROUP #
1007307260034OtherPAMEDICAID GROUP #
25-1716306OtherPAMULTIPLAN/PHCS
102556669 0001MedicaidPA
25-1716306OtherPAINTERGROUP

Other names 1

NPPES NPI Registry
  • Tracey Elizabeth Oberholzer Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 29, 2020.

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588118400000",
    "number": "1194785162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 5TH AVENUE",
            "address_2": "SUITE 3",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014232",
            "telephone_number": "717-263-9555",
            "fax_number": "717-217-4217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 ST PAUL DR STE 210",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172011035",
            "telephone_number": "717-217-6820",
            "fax_number": "717-217-6942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24 Antrim Commons Dr",
            "address_purpose": "LOCATION",
            "city": "Greencastle",
            "state": "PA",
            "postal_code": "172251623",
            "country_code": "US",
            "telephone_number": "717-217-6820",
            "fax_number": "717-217-6942",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "354 Alexander Spring Rd Ste 3",
            "address_purpose": "LOCATION",
            "city": "Carlisle",
            "state": "PA",
            "postal_code": "170157451",
            "country_code": "US",
            "telephone_number": "717-217-6820",
            "fax_number": "717-217-6942",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "601 E Main St",
            "address_purpose": "LOCATION",
            "city": "Waynesboro",
            "state": "PA",
            "postal_code": "172682332",
            "country_code": "US",
            "telephone_number": "717-217-6820",
            "fax_number": "717-217-6942",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILEY",
        "first_name": "TRACEY",
        "middle_name": "ELIZABETH",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2020-04-29",
        "certification_date": "2020-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "TP005855B",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102556669",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "TP005855B",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP #",
            "identifier": "867633",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID GROUP #",
            "identifier": "1007307260034",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN/PHCS",
            "identifier": "25-1716306",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102556669 0001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERGROUP",
            "identifier": "25-1716306",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACEY",
            "last_name": "OBERHOLZER",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chambersburg, PA

Sources for this page

Verify at the official NPI Registry.