Individual provider Active NPI

Michael Joshua Wakely, MD

  • Emergency Medicine Physician
  • Orange Park, FL
National Provider Identifier
1447836846
Registry record updated Apr 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
036.169314 Issued in IL
Practice address
2001 Kingsley Ave
Orange Park, FL 32073-5148
Phone
(904) 639-2000
Fax
(904) 639-2015
NPI assigned
Mar 24, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 036.169314 IL Primary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 83615-20 WI

Addresses

Primary practice location

2001 Kingsley Ave
Orange Park, FL 32073-5148

Mailing address

2880 Osmundsen Rd
Fitchburg, WI 53711-5161
Phone (608) 335-1509

Other practice location 1

1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000

Other practice location 2

8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-7000

Other practice location 3

1000 Mineral Point Ave
Janesville, WI 53548-2982
Phone (608) 756-6868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240828001757 WI Practitioner - Emergency Medicine 8325587884 Reassigns benefits to 2 organizations
I20240828002271 IL Practitioner - Emergency Medicine 8325587884 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health System CorporationGroup PAC ID 7416860440, shared by 14 NPIs, 749 clinicians
Freeport Memorial HospitalGroup PAC ID 8426958232, 168 clinicians
Rockford Health PhysiciansGroup PAC ID 2567374036, 520 clinicians

Practice addresses (Care Compare)

1000 Mineral Point Ave
Janesville, WI 53548-2940
Phone (608) 756-6000

1045 W Stephenson St
Freeport, IL 61032-4864
Phone (815) 599-6000

8201 E Riverside Blvd
Rockford, IL 61114-2300
Phone (815) 971-2000

901 Grant St
Harvard, IL 60033-1821
Phone (815) 943-5431

Hospital & facility affiliations

  • Javon Bea Hospital Hospital, Rockford, IL, CCN 140239
  • Mercy Walworth Hospital & Medical Center Hospital, Lake Geneva, WI, CCN 521357
  • Mercy Health System Corp Hospital, Janesville, WI, CCN 520066

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.169314ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Harvard Hospital Inc CurrentSince Dec 1, 2025 Accepting new patients
Mercy Health System Corporation Current Accepting new patients
Mercy Health System Corporation CurrentSince Aug 1, 2024 Accepting new patients
Rockford Health Physicians CurrentSince Aug 1, 2024 Accepting new patients
Mercy Harvard Hospital Inc CurrentSince Dec 1, 2025 Accepting new patients
Mercy Health System Corporation CurrentSince Aug 1, 2024 Accepting new patients

Locations

29624 Network Pl
Chicago, IL 60673
Phone (608) 741-7652

875 S State Route 31
Crystal Lake, IL 60014
Phone (779) 220-5500

1045 W Stephenson St
Freeport, IL 61032
Phone (815) 599-6105

901 Grant St
Harvard, IL 60033
Phone (815) 943-5431

348 S Division St
Harvard, IL 60033
Phone (815) 943-1122

8201 E Riverside Blvd
Rockford, IL 61114
Phone (815) 971-4066

2300 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-5510

2400 N Rockton Ave
Rockford, IL 61103
Phone (815) 971-6310

3400 Deerfield Dr
Janesville, WI 53546
Phone (608) 314-3600

1000 Mineral Point Ave
Janesville, WI 53548
Phone (608) 261-6868

N2950 State Road 67
Lake Geneva, WI 53147
Phone (262) 245-0535

Interoperability endpoints

  • Direct secure messaging: mwakely117832@direct.mhemail.org

Organizations & group practices 8

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 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": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775088000000",
    "number": "1447836846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 OSMUNDSEN RD",
            "city": "FITCHBURG",
            "state": "WI",
            "postal_code": "537115161",
            "telephone_number": "608-335-1509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 KINGSLEY AVE",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "320735148",
            "telephone_number": "904-639-2000",
            "fax_number": "904-639-2015"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1045 W Stephenson St",
            "address_purpose": "LOCATION",
            "city": "Freeport",
            "state": "IL",
            "postal_code": "610324864",
            "country_code": "US",
            "telephone_number": "815-599-6000",
            "fax_number": "815-599-7974",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8201 E Riverside Blvd",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611142300",
            "country_code": "US",
            "telephone_number": "815-971-7000",
            "fax_number": "815-968-4795",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Mineral Point Ave",
            "address_purpose": "LOCATION",
            "city": "Janesville",
            "state": "WI",
            "postal_code": "535482982",
            "country_code": "US",
            "telephone_number": "608-756-6868",
            "fax_number": "608-756-6289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAKELY",
        "first_name": "MICHAEL",
        "middle_name": "JOSHUA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-24",
        "last_updated": "2026-04-02",
        "certification_date": "2026-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036.169314",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WI",
            "license": "83615-20",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

Verify at the official NPI Registry.