Codie Wiley

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

576 Jefferson Ave BLDG 576
Fort Eustis, VA 23604-1373

Phone

(757) 314-7500

NPI assigned

Feb 2, 2018

Last updated

Jan 5, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in VA

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

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

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1366941684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 JEFFERSON AVE BLDG 576",
            "city": "FORT EUSTIS",
            "state": "VA",
            "postal_code": "236041373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 JEFFERSON AVE BLDG 576",
            "city": "FORT EUSTIS",
            "state": "VA",
            "postal_code": "236041373",
            "telephone_number": "757-314-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "CODIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-02",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ramona L Watson, PH.D.
• Susan Kathleen Webb, R.D.
• Julie Sperling West, PHARMD
• Mya R White, MSPT
• Thomas C. White, M.D.
• Whitney B Worby, LCSW
• Eileen Sharon Wren, MSN RN
• Edward Eugene Yackel, MSN,APRN-BC (FNP)
• Atmaram Yarlagadda, MD
• Julie Sohyun Yi, RD

• Physician Assistant in Fort Eustis, VA
• Providers in Fort Eustis, VA by specialty
• Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.