Active NPI
Jeremy Wiles
- In Home Supportive Care Agency
- Antioch, CA
National Provider Identifier
1841097441
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- 002973429
- Practice address
- 3570 E 18TH St Apt 303
Antioch, CA 94509-7448 - Phone
- (925) 504-7968
- NPI assigned
- Mar 1, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | 002973429 | CA | Primary |
Addresses
Primary practice location
3570 E 18TH St Apt 303
Antioch, CA 94509-7448
Mailing address
3570 E 18TH St Apt 303
Antioch, CA 94509-7448
Phone (925) 504-7968
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002973429 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 002973429 | CA | MD | In Home Supportive Care Agency |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740787200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740787200000",
"number": "1841097441",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3570 E 18TH ST APT 303",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945097448",
"telephone_number": "925-504-7968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3570 E 18TH ST APT 303",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945097448",
"telephone_number": "925-504-7968"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILES",
"first_name": "JEREMY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-03-01",
"last_updated": "2025-03-01",
"certification_date": "2025-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "CA",
"license": "002973429",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002973429",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Antioch, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.