Individual provider Active NPI

Mary Ann Douglas Wilkie, M.D.

  • Emergency Medicine Physician
  • Augusta, GA
National Provider Identifier
1639376205
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
002458 Issued in GA
Practice address
1120 15TH St
Augusta, GA 30912-0004
Phone
(706) 721-3052
NPI assigned
Jun 28, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 002458 GA Primary

Addresses

Primary practice location

1120 15TH St
Augusta, GA 30912-0004

Mailing address

1120 15TH St
Augusta, GA 30912-0004
Phone (706) 721-3052

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140721002509 GA Practitioner - Emergency Medicine 8921292434 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Medical College of Georgia School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acs Primary Care Physicians - Southeast PCGroup PAC ID 5193620714, 409 clinicians

Practice addresses (Care Compare)

3651 Wheeler Rd
Augusta, GA 30909-6521
Phone (706) 651-3232

Hospital & facility affiliations

  • Doctors Hospital Hospital, Augusta, GA, CCN 110177

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002458GAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Peach State Emergency Physicians LLC Emergency Medicine CurrentSince Apr 23, 2025 Accepting new patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Jul 31, 2019 Accepting new patients

Locations

1350 Walton Way
Augusta, GA 30901
Phone (706) 722-9011

3651 Wheeler Rd
Augusta, GA 30909
Phone (706) 651-3232

2151 W Spring St
Monroe, GA 30655
Phone (770) 267-1792

2460 Washington Rd
Thomson, GA 30824
Phone (706) 595-1411

Organizations & group practices 2

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": "1182988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639376205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309120004",
            "telephone_number": "706-721-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKIE",
        "first_name": "MARY ANN",
        "middle_name": "DOUGLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "002458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.