Individual provider Active NPI

Kathleen Wiley, ARNP

  • Nurse Practitioner
  • Concord, NH
National Provider Identifier
1871797985
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
03936323 Issued in NH
Practice address
250 Pleasant St
Concord, NH 03301-2598
Phone
(603) 227-7000
Fax
(603) 227-7582
NPI assigned
Jun 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Health Nurse Practitioner 363LX0106X 039363-23-05 NH
Nurse Practitioner 363L00000X 03936323 NH Primary

Addresses

Primary practice location

250 Pleasant St
Concord, NH 03301-2598

Mailing address

250 Pleasant St
Concord, NH 03301-7559
Phone (603) 227-7000

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20231220002198 NH Practitioner - Nurse Practitioner 0244680098 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03936323NHMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Concord Hospital, Inc. CurrentSince Nov 13, 2023 Accepting new patients
Concord Hospital, Inc. CurrentSince Nov 13, 2023 Accepting new patients
Elliot Hospital Past Accepting new patients

Locations

250 Pleasant St
Concord, NH 03301
Phone (603) 225-2711

248 Pleasant St
Ste 206
Concord, NH 03301
Phone (603) 230-7266

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1871797985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 PLEASANT ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033017559",
            "telephone_number": "603-227-7000",
            "fax_number": "603-227-7582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PLEASANT ST",
            "city": "CONCORD",
            "state": "NH",
            "postal_code": "033012598",
            "telephone_number": "603-227-7000",
            "fax_number": "603-227-7582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILEY",
        "first_name": "KATHLEEN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-13",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LX0106X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Occupational Health",
            "state": "NH",
            "license": "039363-23-05",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NH",
            "license": "03936323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NH

Sources for this page

Verify at the official NPI Registry.