Individual provider Active NPI

Terri H Wildes, NP-C

  • Nurse Practitioner
  • Perry, GA
National Provider Identifier
1710388301
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN076912 Issued in GA
Practice address
400 Silo Cir
Perry, GA 31069-9832
Phone
(229) 560-8181
NPI assigned
Sep 15, 2014
Last updated
Oct 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN076912 GA Primary

Addresses

Primary practice location

400 Silo Cir
Perry, GA 31069-9832

Mailing address

400 Silo Cir
Perry, GA 31069-9832
Phone (229) 560-8181

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150115002059 GA Practitioner - Nurse Practitioner 4284958547 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.72 of 100Reported as group
Quality
88.23
Promoting interoperability
96
Improvement activities
40
Cost
87.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jpfo, LLC CurrentSince Sep 1, 2014 Accepting new patients
Cole Dermatology LLC CurrentSince Sep 1, 2014 Accepting new patients

Locations

2410 N Oak St
Valdosta, GA 31602
Phone (229) 241-7546

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1410739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1710388301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 SILO CIR",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "310699832",
            "telephone_number": "229-560-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SILO CIR",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "310699832",
            "telephone_number": "229-560-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDES",
        "first_name": "TERRI",
        "middle_name": "H",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-15",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN076912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perry, GA

Sources for this page

Verify at the official NPI Registry.