Jerry William Wiley, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

21616 Issued in NC

Practice address

1801 Glendale Dr SW
Wilson, NC 27893-4401

Phone

(252) 237-3141

Fax

(252) 293-8301

NPI assigned

Feb 21, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1457496747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 WESTMINSTER DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276046026",
            "telephone_number": "919-876-9036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 GLENDALE DR SW",
            "city": "WILSON",
            "state": "NC",
            "postal_code": "278934401",
            "telephone_number": "252-237-3141",
            "fax_number": "252-293-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "JERRY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "21616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "13656",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8913656",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kendrick Carrol White, MD
• Tyree Barnes White, MSW, LCSW
• Cindy Taylor Whitley, CPHT
• Tiara Bianca Wiley-King, NP
• Brittany Wiley
• Jamie Kate Wilkerson, PT
• William M Batchelor Jr DDS PA
• Barbara Marie Williams, PA-C
• Courtney Hudson Williams, P.T.
• Dolan Dwight Williams, MSW, LCSW

• Pediatrics Physician in Wilson, NC
• Providers in Wilson, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.