Active NPI
Scott E Wiley, M.D.
- Family Medicine Physician
- Cape Coral, FL
National Provider Identifier
1386625614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- ME64609
- Practice address
- 1255 Viscaya Pkwy Ste 200
Cape Coral, FL 33990-3290 - Phone
- (239) 574-1988
- Fax
- (239) 574-1435
- NPI assigned
- Nov 14, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | ME64609 | FL | Primary |
Addresses
Primary practice location
1255 Viscaya Pkwy Ste 200
Cape Coral, FL 33990-3290
Mailing address
12730 New Brittany Blvd Ste 602
Fort Myers, FL 33907-4690
Phone (239) 275-5522
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 374243100 | Medicaid | FL | |
| 23547 | Other | FL | BC/BS OF FLORIDA |
| 28005 | Other | FL | STAYWELL |
| 210682 | Other | FL | AVMED |
| 000013683G | Other | FL | HUMANA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME64609 | FL | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597968000000",
"number": "1386625614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12730 NEW BRITTANY BLVD STE 602",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339074690",
"telephone_number": "239-275-5522",
"fax_number": "239-275-4464"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1255 VISCAYA PKWY STE 200",
"city": "CAPE CORAL",
"state": "FL",
"postal_code": "339903290",
"telephone_number": "239-574-1988",
"fax_number": "239-574-1435"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILEY",
"first_name": "SCOTT",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-14",
"last_updated": "2020-08-21",
"certification_date": "2020-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "FL",
"license": "ME64609",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "374243100",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF FLORIDA",
"identifier": "23547",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STAYWELL",
"identifier": "28005",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "210682",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HUMANA",
"identifier": "000013683G",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cape Coral, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.