Meredith Wild, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149.025448 Issued in IL

Practice address

3111 Williamson County Pkwy
Marion, IL 62959-5235

Phone

(618) 519-9200

Fax

(618) 985-9155

NPI assigned

Mar 29, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Meredith Kiesling Former name

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Integrated Health of Southern Illinois LTDGroup PAC ID 2365401122, 23 clinicians

Shawnee Health Service and Development CorpGroup PAC ID 1658285671, shared by 22 NPIs, 51 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26231/brand/1/csg/1/fhir/r4

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.

• Integrated Health of Southern Illinois, LTD.

  • Sports Medicine (Family Medicine) Physician
  • Harrisburg, IL
  • NPI 1982738274
  Medicare reassignment Care Compare group NPD
• Integrated Health of Southern Illinois

  • Family Medicine Physician
  • Carterville, IL
  • NPI 1790235497
  NPD
• Shawnee Health Service and Development Corp

  • Federally Qualified Health Center (FQHC)
  • Carterville, IL
  • NPI 1639295314

  Clinical

  NPD
• Shawnee Health Service and Development Corp

  • Federally Qualified Health Center (FQHC)
  • Marion, IL
  • NPI 1649405150

  Clinical

  NPD
• Shawnee Health Service and Development Corp

  • Community/Retail Pharmacy
  • Carbondale, IL
  • NPI 1760253447
  NPD
• Shawnee Health Service and Development Corp

  • Federally Qualified Health Center (FQHC)
  • Marion, IL
  • NPI 1881624161

  Clinical

  NPD (past)

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1275237745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 CALIFORNIA ST",
            "address_2": "PO BOX 577",
            "city": "CARTERVILLE",
            "state": "IL",
            "postal_code": "62918",
            "telephone_number": "618-519-9200",
            "fax_number": "618-985-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 WILLIAMSON COUNTY PKWY",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629595235",
            "telephone_number": "618-519-9200",
            "fax_number": "618-985-9155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILD",
        "first_name": "MEREDITH",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.025448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEREDITH",
            "last_name": "KIESLING",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christopher R Whitley, CRNA
• Jennifer Ann Whitt, RN
• Tarryn Kacey Whorton
• George E Wiggins, CRNA
• Maegan Lea Wilbanks, COTA/L
• Catherine Louise Wilkins, R.PH.
• Charity Will, NP
• Krystal Willey, LPN
• Erik Williams
• Jeff Williams

• Clinical Social Worker in Marion, IL
• Providers in Marion, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; 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.