NPIMap

Individual provider Active NPI

Mary Beth Wiles, MD

  • Internal Medicine Physician
  • Blairsville, GA
National Provider Identifier
1407863285
Registry record updated Oct 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
019625 Issued in GA
Practice address
374A Pat Haralson Dr
Blairsville, GA 30512-8409
Phone
(706) 745-5541
Fax
(706) 745-1361
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 019625 GA Primary

Addresses

Primary practice location

374A Pat Haralson Dr
Blairsville, GA 30512-8409

Mailing address

PO Box 1000
Blairsville, GA 30514-1000
Phone (706) 745-5541

Other identifiers 1

IdentifierTypeStateIssuer
000183752AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061218000495 GA Practitioner - Internal Medicine 4082613104 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Medical College of Georgia School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

374 A Pat Haralson Dr
Blairsville, GA 30512-8409
Phone (706) 745-5541

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Beth Wiles, M.D., PC Internal Medicine CurrentSince Dec 18, 2006 Accepting new patients
Wendy L Smith M.D. PC Past Accepting new patients
Mary Elizabeth Wiles, DO, PC Internal Medicine PastSince Aug 1, 2014 Accepting new patients

Locations

374A Pat Haralson Dr
Blairsville, GA 30512
Phone (706) 745-5541

Interoperability endpoints

  • Direct secure messaging: mary.beth.wiles.1@9035.direct.athenahealth.com
  • Direct secure messaging: marybeth.wiles.1@19762.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 7

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255478400000",
    "number": "1407863285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1000",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305141000",
            "telephone_number": "706-745-5541",
            "fax_number": "706-745-1361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374A PAT HARALSON DR",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305128409",
            "telephone_number": "706-745-5541",
            "fax_number": "706-745-1361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILES",
        "first_name": "MARY",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2009-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "019625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000183752A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blairsville, GA

Sources for this page

Verify at the official NPI Registry.