NPIMap

Individual provider Active NPI

Daryl Carson Wiley, M.D.

  • Family Medicine Physician
  • Thomson, GA
National Provider Identifier
1508859448
Registry record updated Apr 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
032327 Issued in GA
Practice address
315 Fluker St
Thomson, GA 30824-2108
Phone
(706) 595-1090
Fax
(706) 595-6010
NPI assigned
Aug 25, 2005
Last updated
Apr 8, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 032327 GA Primary

Addresses

Primary practice location

315 Fluker St
Thomson, GA 30824-2108

Mailing address

315 Fluker St
Thomson, GA 30824-2108
Phone (706) 595-1090

Other identifiers 1

IdentifierTypeStateIssuer
000442604EMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060329000464 GA Practitioner - Family Practice 4688608730 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1321 Interstate Pkwy
Augusta, GA 30909-5626
Phone (706) 945-0810

2467 Golden Camp Rd
Augusta, GA 30906-5515
Phone (706) 790-4440

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Infinite Medical PC Family Medicine CurrentSince Jul 4, 2023 Accepting new patients
Family Care Group of Thomson, Inc Family Medicine CurrentSince May 8, 2002 Accepting new patients
Neighborhood Improvement Project, Inc CurrentSince Mar 1, 2023 Accepting new patients
Neighborhood Improvement Project Inc Family Medicine CurrentSince Mar 1, 2023 Accepting new patients
Family Care Group of Thomson,Inc Family Medicine CurrentSince May 8, 2002 Accepting new patients
PHG Thomson LLC Past Accepting new patients
Neighborhood Improvement Project, Inc. Past Accepting new patients

Locations

2467 Golden Camp Rd
Augusta, GA 30906
Phone (706) 922-0682

22 Maple Ridge Dr
Cartersville, GA 30121
Phone (770) 606-8800

123 N Washington St
Lincolnton, GA 30817
Phone (706) 359-6070

2508 University Dr
Thomson, GA 30824
Phone (706) 595-1090

315 Fluker St
Thomson, GA 30824
Phone (706) 595-1090

250 Skillman St
Ste 202
Brooklyn, NY 11205

Interoperability endpoints

  • Direct secure messaging: daryl.wiley@gadirect.net
  • Direct secure messaging: daryl.wiley1@gadirect.net
  • Direct secure messaging: darylwiley@fcgt.allscriptsdirect.net

Organizations & group practices 11

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 10

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": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1302220800000",
    "number": "1508859448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 FLUKER ST",
            "city": "THOMSON",
            "state": "GA",
            "postal_code": "308242108",
            "telephone_number": "706-595-1090",
            "fax_number": "706-595-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 FLUKER ST",
            "city": "THOMSON",
            "state": "GA",
            "postal_code": "308242108",
            "telephone_number": "706-595-1090",
            "fax_number": "706-595-6010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "DARYL",
        "middle_name": "CARSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2011-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "032327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000442604E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomson, GA

Sources for this page

Verify at the official NPI Registry.