Active NPI
Gene Martin Wiggs II, DO
- Psychiatry Physician
- Lakeland, FL
National Provider Identifier
1912569187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- OS17740
- Practice address
- 304 E Pine St # 5280
Lakeland, FL 33801-4969 - Phone
- (863) 248-2300
- NPI assigned
- Jul 8, 2019
- Last updated
- Dec 7, 2025
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | OS17740 | FL | Primary |
Addresses
Primary practice location
304 E Pine St # 5280
Lakeland, FL 33801-4969
Mailing address
PO Box 917770
Orlando, FL 32891-0001
Phone (813) 821-8038
Other practice location 1
1303 W Kennedy Blvd
Tampa, FL 33606-1848
Phone (813) 893-6330
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IDDWQ | Other | FL | BCBS |
| 114116100 | Medicaid | FL |
Other names 1
- Marty Wiggs
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | gwiggs353432@direct.tgh.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tampa General Hospital | Current | Accepting new patients | |
| University Medical Service Association Inc | Current | Accepting new patients | |
| University Medical Service Association Inc | Psychiatry | Current | Accepting new patients |
| University Medical Service Association Inc | Current | Accepting new patients | |
| Centerstone of Florida, Inc. | Past | Accepting new patients |
Locations
12901 Bruce B Downs Blvd
#62
Tampa, FL 33612
4202 E Fowler Ave
Stop SHS100
Tampa, FL 33620
Phone (813) 974-2331
Interoperability endpoints
- gwiggs353432@direct.tgh.org
- https://epicproxy.et0761.epichosted.com/FHIRProxy/api/FHIR/R4/
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.
-
- Physical Therapist
- Tampa, FL
- NPI 1992742324
-
- General Acute Care Hospital
- Tampa, FL
- NPI 1124558929
-
- Durable Medical Equipment & Medical Supplies
- Tampa, FL
- NPI 1194276576
-
- General Practice Physician
- Tampa, FL
- NPI 1326088295
Psychiatry
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Bradenton, FL
- NPI 1144251638
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765065600000",
"number": "1912569187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 917770",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328910001",
"telephone_number": "813-821-8038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 E PINE ST # 5280",
"city": "LAKELAND",
"state": "FL",
"postal_code": "338014969",
"telephone_number": "863-248-2300"
}
],
"practiceLocations": [
{
"address_1": "1303 W Kennedy Blvd",
"address_purpose": "LOCATION",
"city": "Tampa",
"state": "FL",
"postal_code": "336061848",
"country_code": "US",
"telephone_number": "813-893-6330",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WIGGS",
"first_name": "GENE",
"middle_name": "MARTIN",
"name_suffix": "II",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-07-08",
"last_updated": "2025-12-07",
"certification_date": "2025-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "FL",
"license": "OS17740",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "IDDWQ",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "114116100",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "gwiggs353432@direct.tgh.org",
"affiliation": "N",
"address_1": "1303 W Kennedy Blvd",
"city": "Tampa",
"state": "FL",
"country_code": "US",
"postal_code": "336061848",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "MARTY",
"last_name": "WIGGS",
"code": "5",
"type": "Other Name"
}
]
}
Other providers in Lakeland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2025; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.