Kathleen J Wiley, REGISTERED NURSE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

265277 Issued in SC

Practice address

16 Saint Charles Dr
Guyton, GA 31312-5380

Phone

(912) 996-4743

Fax

(912) 519-0685

NPI assigned

Jul 14, 2023

Last updated

Jul 14, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1689292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1306525514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 SAINT CHARLES DR",
            "city": "GUYTON",
            "state": "GA",
            "postal_code": "313125380",
            "telephone_number": "912-996-4743",
            "fax_number": "912-519-0685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 SAINT CHARLES DR",
            "city": "GUYTON",
            "state": "GA",
            "postal_code": "313125380",
            "telephone_number": "912-996-4743",
            "fax_number": "912-519-0685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "KATHLEEN",
        "middle_name": "J",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-14",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN275180",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "265277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Enrique Velazquez
• Henry Walker Jr., OWNER
• Donya D Wallace, CSFA
• Kristina Wehrer, NP
• Melody Wente, LCSW
• Kaitlin Yelton

• Registered Nurse in Guyton, GA
• Providers in Guyton, GA by specialty
• Registered Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.