Shuntal L Wiley

Primary specialty

DriverTaxonomy code 172A00000X

Practice address

3708 Carl White PL
Chattanooga, TN 37410-1267

Phone

(423) 488-6962

NPI assigned

Nov 16, 2022

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• One Girl Gang LLC

  • Private Vehicle
  • Chattanooga, TN
  • NPI 1598474280
  NPD Authorized official
• One Girl Gang LLC

  • Non-emergency Medical Transport (VAN)
  • Chattanooga, TN
  • NPI 1902518954
  NPD Authorized official

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1760191936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 CARL WHITE PL",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374101267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 CARL WHITE PL",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374101267",
            "telephone_number": "423-488-6962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "SHUNTAL",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "87-3188433",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Ann Wilcut, APRN
• Cleo B Wilde, LCSW
• David Alan Wiles, MD
• Michael Todd Wiles, DPM
• Emily Grace Wiley
• Gary Blaine Wilkerson, ED.D., A.T.C.
• Tyronda Wilkerson
• Justin Grant Wilkes, MD
• Randy Millard Wilkes Jr., ATC
• Haley Abbigail Haren Wilkins, MA, LCP-MSHP TEMPATR

• Driver in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Driver in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.