Individual provider Active NPI

James Marcus Wilder, PA-C

  • Physician Assistant
  • Trion, GA
National Provider Identifier
1942298609
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
6558 Issued in GA
Practice address
160 Central Ave
Trion, GA 30753-1125
Phone
(706) 734-7302
Fax
(706) 734-7356
NPI assigned
Oct 7, 2005
Last updated
Apr 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 6558 GA Primary

Addresses

Primary practice location

160 Central Ave
Trion, GA 30753-1125

Mailing address

PO Box 12938
Calhoun, GA 30703-7013
Phone (706) 602-7800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20130916000413 GA Practitioner - Physician Assistant 8224121801 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Duke University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventist Health System Georgia IncGroup PAC ID 4486568037, 247 clinicians

Practice addresses (Care Compare)

160 Central Ave
Trion, GA 30753-1125
Phone (706) 368-8500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.79 of 100Reported as group
Quality
68.23
Promoting interoperability
100
Improvement activities
40
Cost
74.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
6558GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cabarrus Family Medicine Past Accepting new patients
Sterling Emergency Services of the Southeast, Inc Physician Assistant Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/c32cb33f-ec61-4f25-9140-0b9b174fe4db/
  • Direct secure messaging: jwilder1461685@adventhealth.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1128643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1942298609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12938",
            "city": "CALHOUN",
            "state": "GA",
            "postal_code": "307037013",
            "telephone_number": "706-602-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 CENTRAL AVE",
            "city": "TRION",
            "state": "GA",
            "postal_code": "307531125",
            "telephone_number": "706-734-7302",
            "fax_number": "706-734-7356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "JAMES",
        "middle_name": "MARCUS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-07",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "6558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trion, GA

Sources for this page

Verify at the official NPI Registry.