Individual provider Active NPI

Jeremy Samuel Wilkes, MD

  • Internal Medicine Physician
  • Greenville, NC
National Provider Identifier
1467959601
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2021-00561 Issued in NC
Practice address
2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone
(252) 744-0750
NPI assigned
Apr 12, 2018
Last updated
Jun 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 2021-00561 NC Primary
Pediatrics Physician 208000000X 2021-00561 NC

Addresses

Primary practice location

2100 Stantonsburg Rd
Greenville, NC 27834-2818

Mailing address

500 Lauchwood Dr
Laurinburg, NC 28352-5501
Phone (910) 291-6904

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jwilkes276214@direct.vidanthealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210526000531 NC Practitioner - Internal Medicine 5294082186 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Brody School of Medicine at East Carolina University, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scotland Regional Health NetworkGroup PAC ID 2365573185, 67 clinicians

Practice addresses (Care Compare)

500 Lauchwood Dr
Laurinburg, NC 28352-5501
Phone (910) 291-6904

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vidant Medical Group LLC CurrentSince May 19, 2021 Accepting new patients
Scotland Regional Health Network CurrentSince Sep 6, 2022 Accepting new patients
Scotland Regional Health Network Internal Medicine CurrentSince Sep 6, 2022 Accepting new patients
Scotland Memorial Hospital Inc Past Accepting new patients
Harris Family Practice PLLC Past Accepting new patients

Locations

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

500 Lauchwood Dr
Laurinburg, NC 28352
Phone (856) 848-3227

Interoperability endpoints

  • Direct secure messaging: jwilkes276214@direct.vidanthealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1523491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1467959601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 LAUCHWOOD DR",
            "city": "LAURINBURG",
            "state": "NC",
            "postal_code": "283525501",
            "telephone_number": "910-291-6904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 STANTONSBURG RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278342818",
            "telephone_number": "252-744-0750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKES",
        "first_name": "JEREMY",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-12",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "2021-00561",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2021-00561",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jwilkes276214@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.