Erica Kitchell Wiedl, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME144522 Issued in FL

Practice address

851042 US Highway 17
Yulee, FL 32097-2845

Phone

(904) 225-3824

Fax

(904) 390-7440

NPI assigned

Jan 18, 2006

Last updated

Sep 3, 2020By the provider in NPPES

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 FL

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

Specialty

Family Practice

Education

Uniformed Services Uhs Fe Hebert School of Med, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Baptist Primary Care IncGroup PAC ID 0648177733, 459 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Home Health Care by Bayada Home health agency, Jacksonville, FL, CCN 107482
• Baptist Medical Center - Nassau Hospital, Fernandina Beach, FL, CCN 100140
• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
• Southeast Georgia Health System -- Camden Campus Hospital, Saint Marys, GA, CCN 110146

Merit-based Incentive Payment System (MIPS)

Final score

95.44 of 100Reported as apm

Quality

84.21

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ewiedl28164@baptisthealthsystemjacksonville.direct-ci.com

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.

• Baptist Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1508817529
  Medicare reassignment Care Compare group NPD
• Baptist Primary Care Inc

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1013160704
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Medical Center of Nassau Inc

  dba Baptist Medical Center Nassau

  • General Acute Care Hospital
  • Fernandina Beach, FL
  • NPI 1518024462
  Care Compare affiliation
• Baybap, LLC.

  dba Baptist Home Health Care by BAYADA

  • Home Health Agency
  • Jacksonville, FL
  • NPI 1023612884
  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  dba Baptist Medical Center

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation
• Southeast Georgia Health System, Inc.

  dba Southeast Georgia Health System - Camden Campus

  • General Acute Care Hospital
  • Saint Marys, GA
  • NPI 1194744326
  Care Compare affiliation

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1649250606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45443",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841450443",
            "telephone_number": "904-202-1032",
            "fax_number": "904-376-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851042 US HIGHWAY 17",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320972845",
            "telephone_number": "904-225-3824",
            "fax_number": "904-390-7440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEDL",
        "first_name": "ERICA",
        "middle_name": "KITCHELL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-18",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "23432",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME144522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby-Marie Madison Webb
• Elinor Weisfeld
• Ashanti White
• Cynthia Dawn White, MSN, ARNP, FNP-C
• David Kevin White, MD
• Katrina Lynn Wilford
• Latonya Williams
• Macy Lynn Williams
• Miangel Williams
• Taylor Jordan Williams, M.S. SLP

• Family Medicine Physician in Yulee, FL
• Providers in Yulee, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.