Individual provider Active NPI

Heidi Wiles

  • Massage Therapist
  • Fairbanks, AK
National Provider Identifier
1801233564
Registry record updated Jun 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
990606 Issued in AK
Practice address
3039 Davis Rd
Fairbanks, AK 99709-5234
Phone
(907) 452-3600
NPI assigned
Jun 4, 2013
Last updated
Jun 4, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X 990606 AK Primary

Addresses

Primary practice location

3039 Davis Rd
Fairbanks, AK 99709-5234

Mailing address

PO Box 71886
Fairbanks, AK 99707-1886
Phone (907) 322-2159

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
990606AKMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
White Spruce Medical Inc PastSince Jun 1, 2019 Accepting new patients
Alaska Urological Institute PC Past Accepting new patients

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": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370304000000",
    "number": "1801233564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 71886",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997071886",
            "telephone_number": "907-322-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3039 DAVIS RD",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095234",
            "telephone_number": "907-452-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILES",
        "first_name": "HEIDI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-04",
        "last_updated": "2013-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "AK",
            "license": "990606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; 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.