Individual provider Active NPI

Gregory Mark Wiggins, DPM

  • Foot & Ankle Surgery Podiatrist
  • Vidalia, GA
National Provider Identifier
1477535474
Registry record updated Nov 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
POD000802 Issued in GA
Practice address
205 Arlington Dr
Vidalia, GA 30474-7209
Phone
(912) 537-2559
Fax
(912) 537-9668
NPI assigned
Nov 16, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X POD000802 GA Primary

Addresses

Primary practice location

205 Arlington Dr
Vidalia, GA 30474-7209

Mailing address

205 Arlington Dr
Vidalia, GA 30474-7209
Phone (912) 537-2559

Other identifiers 3

IdentifierTypeStateIssuer
1254360001OtherDMERC
1477535474OtherBLUE CROSS
00725018AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040301000471 GA Practitioner - Podiatry 0648166355 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

205 Arlington Dr
Vidalia, GA 30474-7209
Phone (912) 537-2559

Hospital & facility affiliations

  • Evans Memorial Hospital Hospital, Claxton, GA, CCN 110142

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1945
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
POD000802GAMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Wiggins Foot and Ankle Associates P.C. Foot & Ankle Surgery CurrentSince Nov 1, 1996 Accepting new patients

Locations

205 Arlington Dr
Ste A
Vidalia, GA 30474

205 Arlington Dr
Vidalia, GA 30474
Phone (912) 537-2530

Organizations & group practices 1

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 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": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194912000000",
    "number": "1477535474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 ARLINGTON DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304747209",
            "telephone_number": "912-537-2559",
            "fax_number": "912-537-9668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 ARLINGTON DR",
            "city": "VIDALIA",
            "state": "GA",
            "postal_code": "304747209",
            "telephone_number": "912-537-2559",
            "fax_number": "912-537-9668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGGINS",
        "first_name": "GREGORY",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2007-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "POD000802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "1254360001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1477535474",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00725018A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vidalia, GA

Sources for this page

Verify at the official NPI Registry.