Latasha Wiley

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN11005781 Issued in FL

Practice address

4280 Southside Blvd
Jacksonville, FL 32216-5400

Phone

(904) 998-3677

Fax

(904) 998-4027

NPI assigned

Jan 24, 2020

Sex

Female

Sole proprietor

Yes

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 FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eon Care Clinicians PCGroup PAC ID 1052833951, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: latasha.wiley.1@29290.direct.athenahealth.com

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.

• Eon Care Clinicians PC

  • Nurse Practitioner
  • Germantown, MD
  • NPI 1073332490

  FL

  Medicare reassignment Care Compare group NPD
• Nurse Practitioner Group LLC

  • Contractor
  • Plantation, FL
  • NPI 1780121277
  Medicare reassignment NPD
• Pophealthcare, LLC

  • Nurse Practitioner
  • Jacksonville, FL
  • NPI 1164943957

  Family

  Medicare reassignment NPD
• Rmed LLC

  • Internal Medicine Physician
  • Jacksonville, FL
  • NPI 1508815358
  Medicare reassignment NPD
• Metro Infectious Disease Consultants, LLC

  • Infectious Disease Physician
  • Burr Ridge, IL
  • NPI 1235125717

  FL

  Medicare reassignment NPD
• Pophealthcare, LLC

  • Primary Care Nurse Practitioner
  • Jacksonville, FL
  • NPI 1326617150
  NPD
• Rmed LLC

  • Family Medicine Physician
  • Jacksonville, FL
  • NPI 1205476793
  NPD
• Metro Infectious Disease Consultants LLC

  • Infectious Disease Physician
  • Jonesboro, GA
  • NPI 1770307191
  NPD
• Metro Infectious Disease Consultants, LLC

  • Infectious Disease Physician
  • Plymouth, MI
  • NPI 1841530250
  NPD (past)

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

{
    "created_epoch": "1579824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1821628207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4280 SOUTHSIDE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165400",
            "telephone_number": "904-998-3677",
            "fax_number": "904-998-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4280 SOUTHSIDE BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322165400",
            "telephone_number": "904-998-3677",
            "fax_number": "904-998-4027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "LATASHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-24",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11005781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy L Wiley, M.S., CCC-SLP
• Bridgett Princess Wiley
• Carolyn Wiley
• Christie Lynne Wiley
• Kelvin James Wiley, M.D.
• Shelly Lynn Wiley, PTA
• Tashondra Daniels Wiley
• Wiley'S Cove
• Lisa Wilford
• Annamaria Wilhelm, MD

• Family Nurse Practitioner in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; 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.