NPIMap

Individual provider Active NPI

Jessica Ann Wiles, APRN, FNP-BC

  • Family Nurse Practitioner
  • Lubbock, TX
National Provider Identifier
1992374912
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1045210 Issued in TX
Practice address
602 Indiana Ave
Lubbock, TX 79415-3364
Phone
(806) 761-0566
Fax
(806) 744-7252
NPI assigned
Jun 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 720620 TX
Family Nurse Practitioner 363LF0000X 1045210 TX Primary

Addresses

Primary practice location

602 Indiana Ave
Lubbock, TX 79415-3364

Mailing address

5219 City Bank Pkwy Ste 35
Lubbock, TX 79407-3545
Phone (806) 761-0334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210719000677 TX Practitioner - Nurse Practitioner 0840692521 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Tech University Health Sciences Center LubbockGroup PAC ID 4385549674, 363 clinicians

Practice addresses (Care Compare)

602 Indiana Ave
Lubbock, TX 79415-3364
Phone (806) 743-2800

Hospital & facility affiliations

  • University Medical Center Hospital, Lubbock, TX, CCN 450686

Merit-based Incentive Payment System (MIPS)

Final score
99.52 of 100Reported as apm
Quality
87.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
720620TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
CSK Medical Partners Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Jun 1, 2024 Accepting new patients
CSK Medical Partners CurrentSince Sep 1, 2022 Accepting new patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Jun 1, 2024 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Current Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients

Locations

6206 Norwich Ave
Lubbock, TX 79424
Phone (806) 792-7200

3601 4th St
Lubbock, TX 79430
Phone (806) 743-1000

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

4110 22nd Pl
Lubbock, TX 79410
Phone (806) 792-4329

Interoperability endpoints

  • Direct secure messaging: jwiles1779513@oc.providencedirect.org

Organizations & group practices 9

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.

Hospital & facility affiliations 5

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": "1624406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1992374912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5219 CITY BANK PKWY STE 35",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794073545",
            "telephone_number": "806-761-0334",
            "fax_number": "806-785-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 INDIANA AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794153364",
            "telephone_number": "806-761-0566",
            "fax_number": "806-744-7252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILES",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-23",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "720620",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1045210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.