Jeremy J Wilber, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

01065140A Issued in IN

Practice address

65 Airport Pkwy Ste 114
Greenwood, IN 46143-1439

Phone

(317) 807-0268

Fax

(317) 528-8115

NPI assigned

May 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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 Medicine

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.

• Cleanslate Medical Group of Indiana LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Alexandria, IN
  • NPI 1023464294
  Medicare reassignment NPD
• Cleanslate Medical Group of Pennsylvania LLC

  • Multi-Specialty Clinic/Center
  • Wilkes Barre, PA
  • NPI 1184177263
  NPD (past)

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1346457934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 AIRPORT PKWY STE 114",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431439",
            "telephone_number": "317-807-0268",
            "fax_number": "317-528-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 AIRPORT PKWY STE 114",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461431439",
            "telephone_number": "317-807-0268",
            "fax_number": "317-528-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBER",
        "first_name": "JEREMY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-16",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01065140A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200916960",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsey Marie Wicker, NP-C
• Brendon Widau, DPT, PT
• Kristin Wietecha
• Natalie Wigand
• Wigs We Care
• Cody B Wilburn, PT, DPT
• Wilfrido M. Tinio MD
• Brooke Wilkerson
• David A. Wilkerson, MSW, LCSW
• Aaron Lee Wilkins, DDS

• Emergency Medicine Physician in Greenwood, IN
• Providers in Greenwood, IN by specialty
• Emergency Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.