Brandy Manche Wiley, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

P9107304 Issued in FL

Practice address

4343 W Newberry Rd
Suite 3
Gainesville, FL 32607-2817

Phone

(352) 374-2222

NPI assigned

Jul 3, 2013

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 identifiers 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• New Smyrna Beach Urgent Care, LLC

  • Basic Emergency Medical Technician
  • New Smyrna Beach, FL
  • NPI 1801126297
  Medicare reassignment
• Paragon Emergency Services LLC

  • Emergency Medicine Physician
  • Winter Haven, FL
  • NPI 1912101650
  Medicare reassignment
• Dolphin Emergency Physicians LLC

  • Emergency Medicine Physician
  • Ocala, FL
  • NPI 1871542712
  NPD (past)
• Florida Em-I Medical Services PA

  • Emergency Medicine Physician
  • Ocala, FL
  • NPI 1881643740
  NPD (past)
• Magnolia Emergency Physicians LLC

  • Emergency Medicine Physician
  • Ocala, FL
  • NPI 1164471090

  Physician Assistant

  NPD (past)
• Simedhealth LLC

  • Internal Medicine Physician
  • Gainesville, FL
  • NPI 1639680127
  NPD (past)

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418688000000",
    "number": "1366882433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4881 NW 8TH AVE",
            "address_2": "SUITE 2",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326054582",
            "telephone_number": "352-547-2373",
            "fax_number": "352-416-1813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4343 W NEWBERRY RD",
            "address_2": "SUITE 3",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326072817",
            "telephone_number": "352-374-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "BRANDY",
        "middle_name": "MANCHE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-03",
        "last_updated": "2014-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "P9107304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009327800",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "Y0P28",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Wilcox
• Shanteria Wilcox
• Paul L Wilder
• Taylah Wiles
• Adolph N Wiley
• Sean David Wiley, R.T.(R)(VI),RPA
• Richard Wilhelm, RN
• Elizabeth Courtney Wilhem, PA-C
• Amber Bland Wilhoit, RD, LD, NSCA-CPT
• Norbert Max Wilke, MD

• Physician Assistant in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; 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.