Jeffrey Wilde MD PLLC

Primary specialty

Rural Health Clinic/CenterTaxonomy code 261QR1300X

Legal business name

JEFFREY WILDE MD PLLC

Practice address

75 Colonia de Salud Ste 200B
Sierra Vista, AZ 85635-2486

Phone

(520) 255-5457

NPI assigned

Jul 25, 2025

Organization subpart

Yes

Parent organization

JEFFERY WILDE MD PLLCAs reported in NPPES

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

Authorized official

Name

Dr. Jeffery Virgil Wilde, MD

Title

MD/Practice Owner

Phone

(520) 255-5475

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Rural health clinic certification: CCN 033855

Legal name

JEFFREY WILDE MD PLLC

Doing business as

WILDE DESERT FAMILY MEDICINE

Certification status

Active

Provider type (POS)

Rural health clinic

Participating since

Dec 19, 2025

Last certification

Dec 19, 2025

Ownership / control type

1A

Organization structure

LLCProprietary

Enrollment address

75 Colonia de Salud
Ste 200B
Sierra Vista, AZ 85635-2486

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Jeffrey Wilde MD PLLC

  • Family Medicine Physician
  • Sierra Vista, AZ
  • NPI 1518515683

  6901138049

  Same PAC ID

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Jeffrey Wilde MD PLLC

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Jeffrey Virgil Wilde, M.D.

  • Family Medicine Physician
  • Sierra Vista, AZ
  • NPI 1073703310

  5% Or Greater Direct Ownership Interest, W-2 Managing Employee

  CMS ownership

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jeffrey Virgil Wilde, M.D.

  • Family Medicine Physician
  • Sierra Vista, AZ
  • NPI 1073703310
  NPD

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

{
    "created_epoch": "1753401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753660800000",
    "number": "1467335737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 EL CAMINO REAL STE 11A",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352825",
            "telephone_number": "520-255-5475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 COLONIA DE SALUD STE 200B",
            "city": "SIERRA VISTA",
            "state": "AZ",
            "postal_code": "856352486",
            "telephone_number": "520-255-5457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY WILDE MD PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JEFFERY WILDE MD PLLC",
        "enumeration_date": "2025-07-25",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A",
        "authorized_official_last_name": "WILDE",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "VIRGIL",
        "authorized_official_title_or_position": "MD/PRACTICE OWNER",
        "authorized_official_telephone_number": "520-255-5475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James B. Leavitt D.M.D., P.C.
• Jamie M Moenster DO PC
• Jill Nmi Japan, RN
• Chantelle Jasso, RN
• Jaya Hari Maddur MD PC
• Jeffrey Wilde MD PLLC
• Jody L Jenkins, M.D.
• Valeria Lozano Jenkins, PT, DPT
• Jordan Faith Jennings
• Barbara Jean Jochum, MSW, LICSW

• Rural Health Clinic/Center in Sierra Vista, AZ
• Providers in Sierra Vista, AZ by specialty
• Rural Health Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.