Individual provider Active NPI

Marcie Starley Wilde, D.O.

  • General Practice Physician
  • Litchfield Park, AZ
National Provider Identifier
1740419365
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
007073 Issued in AZ
Practice address
13840 W Camelback Rd Ste 10
Litchfield Park, AZ 85340-3084
Phone
(928) 323-8112
NPI assigned
Jul 2, 2009
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 007073 AZ Primary

Addresses

Primary practice location

13840 W Camelback Rd Ste 10
Litchfield Park, AZ 85340-3084

Mailing address

13840 W Camelback Rd Ste 10
Litchfield Park, AZ 85340-3084
Phone (928) 323-8112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20220507000031 CO Practitioner - General Practice 6901043868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Touro Un Col of Osteopathic Medicine, Henderson, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Current Care PAGroup PAC ID 9739260019, 545 clinicians

Practice addresses (Care Compare)

402 W Bijou St
Colorado Springs, CO 80905-1309
Phone (719) 302-6942

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
007073AZMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care P.a. CurrentSince May 2, 2022 Accepting new patients
American Current Care PA CurrentSince May 2, 2022 Accepting new patients
Urgent Care Centers of Arizona, LLC Past Accepting new patients
Nextcare Urgent Care PastSince Jun 26, 2017 Accepting new patients

Locations

402 W Bijou St
Colorado Springs, CO 80905
Phone (719) 302-6942

1730 Blake St
Ste 100
Denver, CO 80202
Phone (303) 296-2273

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1740419365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13840 W CAMELBACK RD STE 10",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853403084",
            "telephone_number": "928-323-8112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13840 W CAMELBACK RD STE 10",
            "city": "LITCHFIELD PARK",
            "state": "AZ",
            "postal_code": "853403084",
            "telephone_number": "928-323-8112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDE",
        "first_name": "MARCIE",
        "middle_name": "STARLEY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "AZ",
            "license": "007073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Litchfield Park, AZ

Sources for this page

Verify at the official NPI Registry.