Shannon Wiles, APRN
Individual provider Active NPI Family Nurse Practitioner · Willisburg, KY
NPI 1982145975 · NPPES record last updated Mar 3, 2025
Key facts
- NPI
- 1982145975
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 3011177 (KY)
- Practice address
- 2084 Main St
Willisburg, KY 40078-8199 - Phone
- (859) 375-9200
- NPI assigned
- Mar 10, 2017
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 8
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170526000174 | KY | Practitioner - Nurse Practitioner | 2567739329 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ephraim McDowell Regional Medical Center, Incorporated | Current |
Accepting new patients | |
| Ephraim McDowell Regional Medical Center, Incorporated | Current |
Accepting new patients | |
| Ephraim McDowell Regional Medical Center Incorporated | Current | Accepting new patients | |
| 24 On Physicians, PC | Current |
Accepting new patients | |
| Isaiah House, Inc. | Current |
Accepting new patients | |
| 24 On Physicians, P.C. | Current |
Accepting new patients | |
| Isaiah House Inc | Past |
Accepting new patients | |
| Isaiah House Inc | Past | Accepting new patients |
Locations
318 Maxwell Rd
Ste 500
Alpharetta, GA 30009
Phone (770) 274-0473
100 Broadway
Ste 101
Chaplin, KY 40012
100 Broadway
Ste 102
Chaplin, KY 40012
975 Hustonville Rd
Ste 7
Danville, KY 40422
Phone (859) 239-9598
520 Techwood Dr N
Ste 100
Danville, KY 40422
Phone (859) 236-2203
520 Techwood Dr N
Danville, KY 40422
Phone (859) 236-2203
975 Hustonville Rd
Ste 9
Danville, KY 40422
Phone (859) 209-2331
217 S 3rd St
Danville, KY 40422
Phone (859) 239-1000
110 Diagnostic Dr
Ste B
Frankfort, KY 40601
Phone (502) 227-3383
535 W Second St
Ste 300
Lexington, KY 40508
1191 Hillview Blvd
Ste 2
Louisville, KY 40229
10803 Deering Rd
Louisville, KY 40272
95 Bogle Office Park Dr
Somerset, KY 42503
Phone (606) 677-1451
2042 Main St
Willisburg, KY 40078
2084 Main St
Willisburg, KY 40078
5130 Parkway Plaza Blvd
Charlotte, NC 28217
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 3011177 | KY | Yes |
Addresses
Primary practice location
2084 Main St
Willisburg, KY 40078-8199
Mailing address
2084 Main St
Willisburg, KY 40078-8199
Phone (859) 375-9200
Other providers in Willisburg, KY
- Amanda Oneal-Edelen
- Rachael Parsons
- Shannon Price
- The Good Clinic, LLC
- Lynnsey Kaitlin Vandeventer
- Dennis James Yaste
All providers in Willisburg, KY · Family Nurse Practitioner in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.