Individual provider Active NPI

Jodi Lee Wiley, DO

  • Family Medicine Physician
  • Tulsa, OK
National Provider Identifier
1851974653
Registry record updated Feb 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
7654 Issued in OK
Practice address
6717 S Yale Ave Ste 210
Tulsa, OK 74136-3328
Phone
(918) 675-0068
Fax
(918) 675-5345
NPI assigned
Apr 30, 2021
Last updated
Feb 27, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 7654 OK Primary
Pain Medicine Physician 208VP0000X 7654 OK

Addresses

Primary practice location

6717 S Yale Ave Ste 210
Tulsa, OK 74136-3328

Mailing address

PO Box 38602
Belfast, ME 04915-1228
Phone (918) 675-0068

Other practice location 1

2345 Southwest Blvd Osu Health Care Center
Tulsa, OK 74107
Phone (918) 582-1980

Other practice location 2

2028 Mahaney Ave
Tahlequah, OK 74464-5783
Phone (918) 992-6050

Other practice location 3

1129 S Aspen Ave
Broken Arrow, OK 74012-4859
Phone (539) 637-1253

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20220803003956 OK Practitioner - General Practice 4284016429 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vitality Health Solutions LLCGroup PAC ID 7618419409, 2 clinicians
Muskogee Family PracticeGroup PAC ID 5294177341, 2 clinicians
Domed Enterprises PLLCGroup PAC ID 2860934775, 2 clinicians

Practice addresses (Care Compare)

1118 W Broadway St
Muskogee, OK 74401-6246
Phone (918) 912-7040

209 S 36TH St
Suite a
Muskogee, OK 74401-5043
Phone (918) 681-7554

6717 S Yale Ave
Suite 210
Tulsa, OK 74136-3328
Phone (918) 675-0068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
7654OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Domed Enterprises PLLC Pain Medicine CurrentSince May 28, 2024 Accepting new patients
Provectus Diagnostics LLC CurrentSince Sep 15, 2022 Accepting new patients
Precision Pain Management LLC CurrentSince Sep 15, 2022 Accepting new patients

Locations

8901 S Santa Fe Ave
Ste E
Oklahoma City, OK 73139
Phone (405) 605-5757

4110 S 100th East Ave
Ste 201
Tulsa, OK 74146
Phone (918) 857-7246

6717 S Yale Ave
Ste 210
Tulsa, OK 74136
Phone (918) 675-0068

Interoperability endpoints

  • Direct secure messaging: jodi.wiley.1@31524.direct.athenahealth.com

Organizations & group practices 5

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": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772150400000",
    "number": "1851974653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 38602",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049151228",
            "telephone_number": "918-675-0068",
            "fax_number": "918-675-5345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6717 S YALE AVE STE 210",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741363328",
            "telephone_number": "918-675-0068",
            "fax_number": "918-675-5345"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2345 SOUTHWEST BLVD OSU HEALTH CARE CENTER",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "74107",
            "country_code": "US",
            "telephone_number": "918-582-1980",
            "fax_number": "918-561-1289",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2028 Mahaney Ave",
            "address_purpose": "LOCATION",
            "city": "Tahlequah",
            "state": "OK",
            "postal_code": "744645783",
            "country_code": "US",
            "telephone_number": "918-992-6050",
            "fax_number": "833-763-2349",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1129 S Aspen Ave",
            "address_purpose": "LOCATION",
            "city": "Broken Arrow",
            "state": "OK",
            "postal_code": "740124859",
            "country_code": "US",
            "telephone_number": "539-637-1253",
            "fax_number": "539-367-3311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILEY",
        "first_name": "JODI",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-30",
        "last_updated": "2026-02-27",
        "certification_date": "2026-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "7654",
            "primary": true
        },
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "OK",
            "license": "7654",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tulsa, OK

Sources for this page

Verify at the official NPI Registry.