Benjamin W Wiley, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

35989 Issued in TN

Practice address

1039 Executive Dr Ste 101
Hixson, TN 37343-7900

Phone

(423) 874-0125

Fax

(423) 874-0154

NPI assigned

Apr 20, 2006

Last updated

Apr 6, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

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.

• Galen Medical Group, PC

  • Internal Medicine Physician
  • Hixson, TN
  • NPI 1346250057

  Pediatrics

  Medicare reassignment NPD Authorized official
• Galen Medical Group PC

  dba Galen Pharmacy

  • Non-Pharmacy Dispensing Site
  • Chattanooga, TN
  • NPI 1891248092
  NPD Authorized official
• Galen Pharmacy, LLC

  • Community/Retail Pharmacy
  • Hixson, TN
  • NPI 1851921530
  NPD
• Southeastern Emergency Physicians of Memphis LLC

  • Emergency Medicine Physician
  • Alton, IL
  • NPI 1437105277
  NPD (past)

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1780649780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4976 ALPHA LN",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373435470",
            "telephone_number": "423-497-5355",
            "fax_number": "423-308-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 EXECUTIVE DR STE 101",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373437900",
            "telephone_number": "423-874-0125",
            "fax_number": "423-874-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "BENJAMIN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "35989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Bradley Wheeler, DC
• Zachary Whitener
• Irina Beregovsky Whitten, PHARMD
• Debra Wiertel, D.C
• Kirk A. Wilcox, M.D.
• Sara Elizabeth Wilkens, AU.D.
• Jonathan E Willard, ED.D.
• William a. Hensley
• William E Matthews MD PC
• Autumn Gene Williams, ATC

• Pediatrics Physician in Hixson, TN
• Providers in Hixson, TN by specialty
• Pediatrics Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; 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.