Wendell Hayden Wilmoth, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

7852 Issued in AK

Practice address

1915 E Rezanof Dr
Kodiak, AK 99615-6602

Phone

(907) 486-9581

NPI assigned

Jun 6, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NM, WA, CO, ID, OR, PA, IN, OH, SC, FL, NC, NJ, TN, TX, IL, OK16 enrollments

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 16

Specialty

Diagnostic Radiology

Education

University of New Mexico School of Medicine, 2008

Medicare assignment

May accept Medicare assignment

Group practices

Garden State Healthcare Associates LLCGroup PAC ID 8426190687, 171 clinicians

Family Practice Center PCGroup PAC ID 0244124212, 351 clinicians

Wilmington Health PLLCGroup PAC ID 6103722509, 364 clinicians

Millennium Physician Group LLCGroup PAC ID 9830244433, 976 clinicians

KND Development 59 LLCGroup PAC ID 3678602802, shared by 22 NPIs, 176 clinicians

Colonial Family Practice LLCGroup PAC ID 9931017118, 58 clinicians

American Health Network of Indiana LLCGroup PAC ID 9830093533, 204 clinicians

American Health Network of Ohio, LLCGroup PAC ID 3173427721, 54 clinicians

Summit Medical Group, PLLCGroup PAC ID 2860396330, 636 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carepoint Health - Bayonne Medical Center Hospital, Bayonne, NJ, CCN 310025
• Carepoint Health-Hoboken University Medical Center Hospital, Hoboken, NJ, CCN 310040
• Heights University Hospital Hospital, Jersey City, NJ, CCN 310016

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles (39 of 40)

Locations (25 of 30)

Networks

• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: wendell.wilmoth.p1@direct.wilmingtonhealth.nextgenshare.com
• FHIR API: https://fhir-myrecord.cerner.com/r4/1762c86e-d105-4afc-a3d1-9e89748c9af3/

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.

• American Health Network of Indiana, LLC

  • Internal Medicine Physician
  • Indianapolis, IN
  • NPI 1831236272
  Medicare reassignment Care Compare group NPD
• American Health Network of Ohio, LLC

  • Family Medicine Physician
  • Columbus, OH
  • NPI 1386675544
  Medicare reassignment Care Compare group NPD
• Colonial Family Practice, LLC

  • Family Medicine Physician
  • Sumter, SC
  • NPI 1518074640
  Medicare reassignment Care Compare group NPD
• Family Practice Center, PC

  • Physical Therapist
  • Middleburg, PA
  • NPI 1154376937
  Medicare reassignment Care Compare group NPD
• Garden State Healthcare Associates, LLC

  • Emergency Medicine Physician
  • Bayonne, NJ
  • NPI 1700014545

  WA

  Medicare reassignment Care Compare group NPD
• Millennium Physician Group LLC

  • Family Medicine Physician
  • Fort Myers, FL
  • NPI 1811122880
  Medicare reassignment Care Compare group NPD
• Summit Medical Group, PLLC

  • Internal Medicine Physician
  • Brentwood, TN
  • NPI 1659090298
  Medicare reassignment Care Compare group NPD
• Wilmington Health PLLC

  • Multi-Specialty Clinic/Center
  • Wilmington, NC
  • NPI 1881632339
  Medicare reassignment Care Compare group NPD
• American Health Network of Ohio, LLC

  • Radiology Clinic/Center
  • Columbus, OH
  • NPI 1548142987

  WA

  Medicare reassignment NPD
• Family First Medical Center, PLLC

  • Family Medicine Physician
  • Idaho Falls, ID
  • NPI 1033314273
  Medicare reassignment NPD
• Fanno Creek Clinic LLC

  • Internal Medicine Physician
  • Portland, OR
  • NPI 1609876705
  Medicare reassignment NPD
• Greater Phoenix Collaborative Care PC

  • Clinic/Center
  • Phoenix, AZ
  • NPI 1750686614

  WA

  Medicare reassignment NPD

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

• Hudson Hospital Opco LLC

  • General Acute Care Hospital
  • Jersey City, NJ
  • NPI 1871859306
  Care Compare affiliation
• Humc Opco LLC

  • General Acute Care Hospital
  • Hoboken, NJ
  • NPI 1043475668
  Care Compare affiliation
• Ijkg Opco LLC

  • General Acute Care Hospital
  • Bayonne, NJ
  • NPI 1821101239
  Care Compare affiliation

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765238400000",
    "number": "1245499003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10107",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379390107",
            "telephone_number": "865-584-7376",
            "fax_number": "865-540-3856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1915 E REZANOF DR",
            "city": "KODIAK",
            "state": "AK",
            "postal_code": "996156602",
            "telephone_number": "907-486-9581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7211 Wellington Dr Ste 101",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379195968",
            "country_code": "US",
            "telephone_number": "865-588-8005 x44747",
            "fax_number": "865-588-8005",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13813 Metro Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339124343",
            "country_code": "US",
            "telephone_number": "855-674-4624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILMOTH",
        "first_name": "WENDELL",
        "middle_name": "HAYDEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-06",
        "last_updated": "2025-12-09",
        "certification_date": "2025-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TN",
            "license": "75934",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AK",
            "license": "7852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1585319",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Marie Wheeler
• Desiree Alexis Wheeler, OD
• Roxann Marie White, MSPT
• Joel Gregory Wiersum Sr., DDS
• Dorianne Emily Williams, FNP
• Brandon James Wilson, PA-C
• Evelyn Wiszinckas, PH.D.
• Melissa Witteveen, PA-C
• Alan W Wolf, MD
• Diane C Wolkoff

• Diagnostic Radiology Physician in Kodiak, AK
• Providers in Kodiak, AK by specialty
• Diagnostic Radiology Physician in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; 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.