Gary M Wiltz, M.D.
Individual provider Active NPI Internal Medicine Physician · Franklin, LA
NPI 1477596351 · NPPES record last updated Jun 17, 2022
Key facts
- NPI
- 1477596351
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 015340 (LA)
- Practice address
- 1115 Weber St
Franklin, LA 70538-4124 - Phone
- (337) 828-2550
- Fax
- (337) 355-2335
- NPI assigned
- Jun 14, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 1
Owned or controlled facilities with NPI records 12
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Tulane University School of Medicine, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Teche Action Board Inc
Practice addresses (Care Compare)
1115 Weber St
Franklin, LA 70538-4124
Phone (337) 828-2550
Hospital & facility affiliations
- Bayou Bend Health System
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
All facility ownership & control disclosures 12
| Facility | Type | Role | Since |
|---|---|---|---|
| Teche Health @ Reserve |
Federally qualified health center | Corporate Officer W-2 Managing Employee |
Dec 1, 2009 Dec 1, 2009 |
| Teche Health SBHC @West St Mary H.S |
Federally qualified health center | W-2 Managing Employee Operational/Managerial Control |
Dec 1, 2009 Dec 1, 2009 |
| Teche Health @ Pierre Part |
Federally qualified health center | Corporate Officer (100%) W-2 Managing Employee (100%) |
Nov 30, 2009 Nov 30, 2009 |
| Teche Health @ Franklin |
Federally qualified health center | Corporate Officer W-2 Managing Employee |
Sep 24, 2010 Sep 24, 2010 |
| Teche Health @ Houma East |
Federally qualified health center | W-2 Managing Employee Operational/Managerial Control |
Sep 24, 2010 Sep 24, 2010 |
| Teche Health @ Houma West |
Federally qualified health center | Corporate Director W-2 Managing Employee Operational/Managerial Control |
Sep 24, 2010 Sep 24, 2010 Sep 24, 2010 |
| Teche Health @ Morgan City |
Federally qualified health center | W-2 Managing Employee Operational/Managerial Control |
Dec 5, 2011 Dec 5, 2011 |
| Teche Health @ Thibodaux |
Federally qualified health center | W-2 Managing Employee | Apr 10, 2014 |
| Teche Health SBHC @ East St John High |
Federally qualified health center | Corporate Director W-2 Managing Employee Operational/Managerial Control |
Apr 10, 2014 Apr 10, 2014 Apr 10, 2014 |
| Teche Health @ St. James High School |
Federally qualified health center | W-2 Managing Employee Operational/Managerial Control |
Apr 25, 2022 Apr 25, 2022 |
| Teche Health @ Gramercy |
Federally qualified health center | W-2 Managing Employee Operational/Managerial Control |
Jan 8, 2020 Jan 8, 2020 |
| Teche Health @ Sugarland |
Federally qualified health center | W-2 Managing Employee Operational/Managerial Control |
Apr 25, 2022 Apr 25, 2022 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100827000852 | LA | Practitioner - Internal Medicine | 9133013535 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015340 | LA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teche Action Board, Inc. | Current |
Accepting new patients | |
| Teche Action Board, Inc. | Current |
Accepting new patients | |
| Teche Action Board Inc | Current | Accepting new patients | |
| Teche Diagnostic Imaging Center LLC | Past |
Accepting new patients | |
| Teche Action Board, Inc. | Past | Accepting new patients | |
| Teche Action Board, Inc. | Past | Accepting new patients | |
| Teche Action Board Inc | Past | Accepting new patients | |
| Teche Action Board, Inc. | Past | Accepting new patients | |
| Teche Action Board, Inc. | Past | Accepting new patients |
Locations
18333 Highway 182
Rm 505
Baldwin, LA 70514
Phone (337) 924-9418
159 E 3rd St
Edgard, LA 70049
Phone (985) 497-8726
2555 Highway 18
Edgard, LA 70049
Phone (337) 828-2550
1097 Northwest Blvd
Franklin, LA 70538
Phone (337) 355-1269
1115 Weber St
Franklin, LA 70538
Phone (337) 828-2550
827 N Pine St
Gramercy, LA 70052
Phone (225) 258-9490
1014 W Tunnel Blvd
Houma, LA 70360
Phone (985) 851-1717
5642 W Main St
Houma, LA 70360
Phone (985) 448-3737
189 Mozart Dr
Houma, LA 70363
Phone (985) 868-3700
393 Greenwood Dr
La Place, LA 70068
Phone (985) 359-6492
1124 7th St
Morgan City, LA 70380
Phone (985) 384-2371
3528 Highway 70 S
Pierre Part, LA 70339
Phone (985) 252-6211
1709 Ridgefield Rd
Thibodaux, LA 70301
Phone (985) 446-7341
22187 Highway 20
Vacherie, LA 70090
Phone (225) 258-4980
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 015340 | LA | Yes |
Addresses
Primary practice location
1115 Weber St
Franklin, LA 70538-4124
Mailing address
1115 Weber St
Franklin, LA 70538-4124
Phone (337) 828-2550
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1321532 | Medicaid | LA | |
| 5M235 | Other | LA | MEDICARE NUMBER |
Other providers in Franklin, LA
- Tatinisha Washington
- Christopher Williams
- Brianna Mijay Wilson
- Ericka R Wilson
- Pamela A. Wilson
- Brennan Young
- Gemma Yumul
All providers in Franklin, LA · Internal Medicine Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 17, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.