Carol Jean Wilder, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD185352 Issued in OR

Practice address

70 Bower Drive
Medford, OR 97501

Phone

(541) 734-3650

Fax

(206) 368-6101

NPI assigned

Oct 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OR

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

Specialty

Sports MedicineAlso: Family Practice

Education

Medical College of Wisconsin, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Immediate Care, LLCGroup PAC ID 7618876723, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Asante Ashland Community Hospital Hospital, Ashland, OR, CCN 380005
• Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
• Providence Medford Medical Center Hospital, Medford, OR, CCN 380075

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JJGIDD/Endpoint/JJGIDD

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.

• Valley Immediate Care, LLC

  • Urgent Care Clinic/Center
  • Medford, OR
  • NPI 1982709226

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Providence Health & Services - Oregon

  • Clinic/Center
  • Medford, OR
  • NPI 1093976243
  Medicare reassignment NPD
• Providence Health & Services - Oregon

  • Clinical Pathology Physician
  • Medford, OR
  • NPI 1285185942

  Family Medicine

  NPD
• Sports Medicine Group

  • Sports Medicine (Family Medicine) Physician
  • Seattle, WA
  • NPI 1629177225
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Asante

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Care Compare affiliation
• Asante Ashland Community Hospital, LLC

  • General Acute Care Hospital
  • Ashland, OR
  • NPI 1730628827
  Care Compare affiliation
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1689755670
  Care Compare affiliation

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1801982749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3158",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083158",
            "telephone_number": "541-732-3650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 BOWER DRIVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97501",
            "telephone_number": "541-734-3650",
            "fax_number": "206-368-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "CAROL",
        "middle_name": "JEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "00048866",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "HI",
            "license": "10509",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "WA",
            "license": "00048866",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD185352",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "49963303",
            "state": "HI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwilder848828@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "70 Bower Drive",
            "city": "Medford",
            "state": "OR",
            "country_code": "US",
            "postal_code": "97501",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cwilder848828@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "1661 Highway 99 N Ste 100",
            "city": "Ashland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "975208900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brittney Wikoff
• Scott Wilber, MD
• John Wilcox
• Marcy J Wilcox, LPC
• Alyssa Kay Wilder, LCSW
• Mary S Wilder, RN
• Jason Ward Wileman, BS, QMHA
• Mali Wileman
• Kadin Gabriel Wiley
• William Kurt Wilkening, O. D.

• Family Medicine Physician in Medford, OR
• Providers in Medford, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.