Jodi Wilder, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS15990 Issued in FL

Practice address

125 Florida Memorial Pkwy Ste 2200
New Smyrna Beach, FL 32168-9309

Phone

(386) 409-6839

Fax

(386) 409-6916

NPI assigned

Sep 7, 2016

Sex

Female

Sole proprietor

No

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

Enrolled in FL

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Adventhealth Primary Care Network Inc

  • Family Medicine Physician
  • Altamonte Springs, FL
  • NPI 1093493637
  NPD

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1336696327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 FLORIDA MEMORIAL PKWY STE 2200",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321689309",
            "telephone_number": "386-409-6839",
            "fax_number": "386-409-6916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 FLORIDA MEMORIAL PKWY STE 2200",
            "city": "NEW SMYRNA BEACH",
            "state": "FL",
            "postal_code": "321689309",
            "telephone_number": "386-409-6839",
            "fax_number": "386-409-6916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "JODI",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "KY",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS15990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Wheeler, PA-C
• Wendy A Whitaker, NP
• Gregory G White, MD
• Chelsea Nicole Whitney, DC
• Catherine Rose Whitten
• Aerial Williams, DC
• Calvin Williams
• Christine Lundberg Williams, M.D.
• Jennifer Lee Williams, DNP, FNP-C
• Robert Williams, M.D.

• Family Medicine Physician in New Smyrna Beach, FL
• Providers in New Smyrna Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.