Individual provider Active NPI

Barbara G Wiles, FNP-BC, MSN, RN

  • Family Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1376707406
Registry record updated Jul 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP3103 Issued in AZ
Practice address
6116 East Arbor Ave
Suite 112
Mesa, AZ 85206
Phone
(480) 641-5400
Fax
(480) 218-4353
NPI assigned
Jul 17, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP3103 AZ Primary

Addresses

Primary practice location

6116 East Arbor Ave
Suite 112
Mesa, AZ 85206

Mailing address

14780 W Mountain View Blvd
Ste 110
Surprise, AZ 85374-7280
Phone (623) 374-7774

Other identifiers 1

IdentifierTypeStateIssuer
370570MedicaidAZ

Other names 1

  • Mrs. Bobbie Wiles Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20081125000085 AZ Practitioner - Nurse Practitioner 3274693080 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
AP3103AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ponderosa Heart House Call CurrentSince Sep 1, 2020 Accepting new patients

Locations

2162 E Williams Field Rd
Ste 111
Gilbert, AZ 85295
Phone (480) 795-1515

3707 E Southern Ave
Ste 2099
Mesa, AZ 85206

3707 E Southern Ave
Ste 1023
Mesa, AZ 85206
Phone (480) 795-1515

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1216252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469404800000",
    "number": "1376707406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14780 W MOUNTAIN VIEW BLVD",
            "address_2": "STE 110",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853747280",
            "telephone_number": "623-374-7774",
            "fax_number": "855-420-6361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6116 EAST ARBOR AVE",
            "address_2": "SUITE 112",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85206",
            "telephone_number": "480-641-5400",
            "fax_number": "480-218-4353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILES",
        "first_name": "BARBARA",
        "middle_name": "G",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC, MSN, RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-17",
        "last_updated": "2016-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP3103",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "370570",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BOBBIE",
            "last_name": "WILES",
            "prefix": "MRS.",
            "credential": "FNP-BC, MSN, RN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.