Jerry Mark Wigley, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

034078 Issued in GA

Practice address

179B Pine Grove Rd.
Cartersville, GA 30120

Phone

(770) 387-4544

Fax

(770) 387-4579

NPI assigned

Jul 19, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jmwigley@jmwm-ga.direct.office.nextgen.com

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.

• Jerry Mark Wigley MD

  • Family Medicine Physician
  • Cartersville, GA
  • NPI 1558628701
  NPD Authorized official

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1699794818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179B PINE GROVE RD",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "30120",
            "telephone_number": "770-387-4544",
            "fax_number": "770-387-4579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179B PINE GROVE RD.",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "30120",
            "telephone_number": "770-387-4544",
            "fax_number": "770-387-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGLEY",
        "first_name": "JERRY",
        "middle_name": "MARK",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "034078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000463152C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frank Thomas White Jr., M.ED-CCC
• Kayleigh White, LCSW
• William Keith White, PA-C
• Joshua Righteous Widjaja, DC
• Dan Wiener, MD
• Amanda Christine Wilbourn, FNP
• Danielle Renay Wiley, CNA, PCT
• Abby Wilkey
• Valenie Wilkins
• Adam Carlisle Wilkinson, PT, DPT

• Family Medicine Physician in Cartersville, GA
• Providers in Cartersville, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; 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.