Allison Marie Wildey, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704360424 Issued in MI

Practice address

26206 W 12 Mile Rd Ste 105
Southfield, MI 48034-1799

Phone

(248) 200-3717

NPI assigned

Feb 14, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: allison.bielski.1@22658.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/22658/brand/1/csg/1/fhir/r4
• FHIR API: https://api.platform.athenahealth.com/14284/brand/1/csg/1/fhir/r4

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.

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  • NPI 1578678819
  Medicare reassignment NPD

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

{
    "created_epoch": "1613260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1497348171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26206 W 12 MILE RD STE 105",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341799",
            "telephone_number": "248-200-3715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26206 W 12 MILE RD STE 105",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341799",
            "telephone_number": "248-200-3717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29519 Maplewood St",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "MI",
            "postal_code": "481353441",
            "country_code": "US",
            "telephone_number": "734-772-2152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILDEY",
        "first_name": "ALLISON",
        "middle_name": "MARIE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-14",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704360424",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704360424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Wilczek
• Wild & Precious Therapy LLC
• Heather Wild
• Brittany Wilder
• Gerald Wilder, RPH
• Jeremy Wiles
• Julie Latham Wiley
• Tiffany Wiley
• Anne Wilhoit
• Koron Jerrell Wilkerson Jr.

• Family Nurse Practitioner in Southfield, MI
• Providers in Southfield, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.