NPIMap

Organization Active NPI

Dana L. Wiley, MD PA

  • Mental Health Counselor
  • Piedmont, SC
National Provider Identifier
1649293085
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
17523 Issued in SC
Legal business name
DANA L. WILEY, MD PA
Practice address
102 Commons Blvd
Suite C
Piedmont, SC 29673-7766
Phone
(864) 220-9115
Fax
(864) 220-9513
NPI assigned
Jul 26, 2006
Last updated
Oct 11, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Authorized official

Name
Dr. Dana Lee Wiley, MDNPI 1427006808
Title
President
Phone
(864) 220-9115

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 17523 SC Primary

Addresses

Primary practice location

102 Commons Blvd
Suite C
Piedmont, SC 29673-7766

Mailing address

102 Commons Blvd
Suite C
Piedmont, SC 29673-7766
Phone (864) 220-9115

Other identifiers 1

IdentifierTypeStateIssuer
GP4113MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050518000804 SC Part B Supplier - Clinic/Group Practice 9436190659 Receives reassigned benefits from 6 practitioners
Practice locations: Piedmont, SC

National Provider Directory

National Provider Directory

Locations

309 W Beltline Blvd
Anderson, SC 29625
Phone (846) 220-9115

4325A Old Mill Rd
Ste 2B
Anderson, SC 29621
Phone (864) 225-1195

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1649293085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 COMMONS BLVD",
            "address_2": "SUITE C",
            "city": "PIEDMONT",
            "state": "SC",
            "postal_code": "296737766",
            "telephone_number": "864-220-9115",
            "fax_number": "864-220-9513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 COMMONS BLVD",
            "address_2": "SUITE C",
            "city": "PIEDMONT",
            "state": "SC",
            "postal_code": "296737766",
            "telephone_number": "864-220-9115",
            "fax_number": "864-220-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANA L. WILEY, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "WILEY",
        "authorized_official_first_name": "DANA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "864-220-9115",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "SC",
            "license": "17523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4113",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Piedmont, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.