Individual provider Active NPI

David A Wiles, APRN-C

  • Nurse Practitioner
  • Tampa, FL
National Provider Identifier
1912459249
Registry record updated Mar 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9311117 Issued in FL
Practice address
3003 W Dr Martin Luther King Jr Blvd FL 2
Tampa, FL 33607-6307
Phone
(813) 397-1251
Fax
(813) 443-8136
NPI assigned
Nov 3, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9311117 FL Primary

Addresses

Primary practice location

3003 W Dr Martin Luther King Jr Blvd FL 2
Tampa, FL 33607-6307

Mailing address

2995 Drew St FL 2
Clearwater, FL 33759-3012
Phone (727) 532-1355

Other identifiers 1

IdentifierTypeStateIssuer
106086700MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address David.Wiles@direct.mybaycare.org Health Information Exchange (HIE) BayCare Medical Group, Inc.

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20180705000197 FL Practitioner - Nurse Practitioner 8022364082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307
Phone (813) 321-6589

3003 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9311117FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc. CurrentSince May 1, 2020 Accepting new patients
Tampa General Hospital Current Accepting new patients
Baycare Medical Group, Inc. Nurse Practitioner CurrentSince May 1, 2020 Accepting new patients

Locations

2995 Drew St
Fl 2
Clearwater, FL 33759
Phone (727) 315-7234

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

2995 Drew St
Bldg 2ND
Clearwater, FL 33759

3003 W Mlk Blvd
Fl 2
Tampa, FL 33607
Phone (813) 321-6580

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: david.wiles@direct.mybaycare.org
  • FHIR API: https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
  • Direct secure messaging: dwiles110276@direct.tgh.org

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": "1478131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1912459249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2995 DREW ST FL 2",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337593012",
            "telephone_number": "727-532-1355",
            "fax_number": "813-635-2613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3003 W DR MARTIN LUTHER KING JR BLVD FL 2",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336076307",
            "telephone_number": "813-397-1251",
            "fax_number": "813-443-8136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILES",
        "first_name": "DAVID",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "APRN-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-11-03",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9311117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106086700",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "David.Wiles@direct.mybaycare.org",
            "affiliation": "Y",
            "affiliationName": "BayCare Medical Group, Inc.",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2995 Drew Street",
            "address_2": "East Bldg 2nd Floor",
            "city": "Clearwater",
            "state": "FL",
            "country_code": "US",
            "postal_code": "33759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tampa, FL

Sources for this page

Verify at the official NPI Registry.