Jennifer Wild, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

3961 Issued in AZ

Practice address

3931 E Camelback Rd
Phoenix, AZ 85018-2609

Phone

(602) 687-7858

NPI assigned

Nov 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jennifer Kraus Former name

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Nextcare Arizona LLC

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1043371826
  Medicare reassignment NPD
• Nextcare Arizona I JV LLC

  • Urgent Care Clinic/Center
  • Tempe, AZ
  • NPI 1114798071
  NPD
• Privia Medical Group Arizona, LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1760441141
  NPD (past)

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399420800000",
    "number": "1629051628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3931 E CAMELBACK RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182609",
            "telephone_number": "602-687-7858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3931 E CAMELBACK RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850182609",
            "telephone_number": "602-687-7858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILD",
        "first_name": "JENNIFER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2014-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "3961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "971623",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "KRAUS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda Wilcox, COTA/L
• Lauren Wilcox, PA-C
• Wild Hearts Rise
• Wild Roots Wellness, PLLC
• Wild Terrain Therapy LLC
• Reece Wild, PA-C
• Susanne Gertraud Wild, M.D.
• Jolyn M. Wilda, CRNA
• Laura Mary Wilda, MSN, FNP-C
• Wildcat Anesthesiology PC

• Family Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; 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.