Individual provider Active NPI

Kimberly Lauren Wiley, NP

  • Family Nurse Practitioner
  • Cumming, GA
National Provider Identifier
1386279362
Registry record updated Feb 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
184643 Issued in GA
Practice address
3970 Deputy Bill Cantrell Mem Ste 100
Cumming, GA 30040-3069
Phone
(678) 513-2273
NPI assigned
Mar 10, 2020
Last updated
Feb 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 184643 GA Primary
Nurse Practitioner 363L00000X 184643 GA

Addresses

Primary practice location

3970 Deputy Bill Cantrell Mem Ste 100
Cumming, GA 30040-3069

Mailing address

6070 Stillwood LN
Cumming, GA 30041-4427
Phone (678) 630-5229

Other practice location 1

1266 Highway 515 S
Jasper, GA 30143-4872
Phone (706) 692-2441

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20200610003476 GA Practitioner - Nurse Practitioner 3779904131 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northside Cardiovascular Professional Services, LLCGroup PAC ID 9739189838, 143 clinicians
Piedmont Cardiology of Atlanta, LLCGroup PAC ID 0345321691, 478 clinicians
Heart and Vascular Care, LLCGroup PAC ID 0941303622, 45 clinicians

Practice addresses (Care Compare)

1200 Northside Forsyth Dr
Cumming, GA 30041-7659
Phone (770) 844-3200

1266 Hwy 515 S
Jasper, GA 30143-4872
Phone (706) 692-2441

73 Prestige LN
Suite 205
Dawsonville, GA 30534-6371
Phone (678) 513-2273

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.65 of 100Reported as group
Quality
90.12
Promoting interoperability
100
Improvement activities
40
Cost
75.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
184643GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Cardiology of Atlanta, LLC CurrentSince Jan 19, 2026 Accepting new patients
Northside Cardiovascular Professional Services, LLC CurrentSince Jul 2, 2025 Accepting new patients
Nmda Anesthesia LLC PastSince Mar 22, 2020 Accepting new patients

Locations

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

1200 Northside Forsyth Dr
Cumming, GA 30041
Phone (770) 292-4806

1266 Highway 515 S
Jasper, GA 30143
Phone (706) 301-5350

220 J L White Dr
Ste 100
Jasper, GA 30143
Phone (706) 253-8001

1285 Upper Hembree Rd
Roswell, GA 30076
Phone (770) 343-8565

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

Interoperability endpoints

  • Direct secure messaging: kimberly.wiley.1@1164.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1583798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770681600000",
    "number": "1386279362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6070 STILLWOOD LN",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300414427",
            "telephone_number": "678-630-5229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3970 DEPUTY BILL CANTRELL MEM STE 100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300403069",
            "telephone_number": "678-513-2273"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1266 Highway 515 S",
            "address_purpose": "LOCATION",
            "city": "Jasper",
            "state": "GA",
            "postal_code": "301434872",
            "country_code": "US",
            "telephone_number": "706-692-2441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILEY",
        "first_name": "KIMBERLY",
        "middle_name": "LAUREN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-10",
        "last_updated": "2026-02-10",
        "certification_date": "2026-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "184643",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "184643",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

Verify at the official NPI Registry.