DR. JERRY WILLIAM WILEY (NPI# 1457496747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457496747 |
| Entity Type | Individual |
| Full Name | DR. JERRY WILLIAM WILEY |
| Credential | M.D. |
| Practice Address |
1801 Glendale Dr Sw Wilson NC 27893-4401 |
| Mailing Address |
4700 Westminster Dr Raleigh NC 27604-6026 |
| Practice Telephone | 2522373141 |
| Practice Fax Number | 2522938301 |
| Mailing Telephone | 9198769036 |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 21616 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | BCBS | 13656 | 01 |
| NC | 8913656 | 05 |
| Street Address |
1801 GLENDALE DR SW |
| City | WILSON |
| State | NC |
| Zip Code | 27893-4401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457357048 | County of Wilson | Home Health | 1801 Glendale Dr Sw, Wilson, NC 27893-4401 | 2005-06-28 |
| 1063810711 | Katrina L Mccourt | Nurse Practitioner | 1801 Glendale Dr Sw, Wilson, NC 27893-4401 | 2014-12-11 |
| 1184989493 | Amber Burgess | Dietitian, Registered | 1801 Glendale Dr Sw, Wilson, NC 27893-4401 | 2012-07-12 |
| 1669768313 | Rebecca J Hunt-hawley | Nurse Practitioner | 1801 Glendale Dr Sw, Wilson, NC 27893-4401 | 2011-06-21 |
| 1235449489 | April Ferrell Nesbit | Dietitian, Registered | 1801 Glendale Dr Sw, Wilson, NC 27893-4401 | 2010-10-20 |
| 1063652675 | Lisa Marie Weppler | Advanced Practice Midwife | 1801 Glendale Dr Sw, Wilson, NC 27893-4401 | 2009-02-23 |
| 1467507640 | County of Wilson | Clinic/Center | 1801 Glendale Dr Sw, Wilson, NC 27893-4401 | 2007-01-25 |
| 1376698555 | County of Wilson | Case Management | 1801 Glendale Dr Sw, Wilson, NC 27893-4401 | 2007-01-25 |
| 1568517746 | County of Wilson | Clinic/Center | 1801 Glendale Dr Sw, Wilson, NC 27893-4401 | 2007-01-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245847524 | Graceland Student Services LLC | Early Intervention Provider Agency | 610 Fairview Ave., Wilson, NC 27893 | 2020-09-30 |
| 1508477894 | Evan Michael Abatiell | Specialist/Technologist | 400 Atlantic Christian E West Ne, Wilson, NC 27893 | 2020-08-11 |
| 1679100606 | Newgreen Inhomecare Group Inc | Registered Nurse | 121 Nast Street N, Wilson, NC 27893 | 2020-03-27 |
| 1942772983 | Open Water Medical, Pa | Clinic/Center | 4008 Nc-42, Wilson, NC 27893 | 2018-12-31 |
| 1679043244 | Madison Rose Propst | Social Worker | 2416 Bedgood, Wilson, NC 27893 | 2018-11-27 |
| 1104396753 | Laboratory Corporation of America Holdings | Clinical Medical Laboratory | 2500 Horton Blvd, Wilson, NC 27893 | 2018-11-27 |
| 1528545498 | North Carolina In-home Partner-viii, LLC | Home Health | 1901 Tarboro St Sw Ste 304, Wilson, NC 27893 | 2018-07-24 |
| 1518478957 | Home Away From Home, Inc. | In Home Supportive Care | 1723 Meadowbrook Lane W., Wilson, NC 27893 | 2017-10-12 |
| 1942721295 | Sandra Susan Blazek | Social Worker | 608 Nash Street Nw, Wilson, NC 27893 | 2017-06-27 |
| 1700306297 | Kimberly Denton Almkuist | Nurse Practitioner | Wilson County Health Department, 1801 Glendale Dr. Sw, Wilson, NC 27893 | 2017-06-26 |
| Find all providers in zip 27893 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780764357 | James R Busch | Pediatrics | 1702 Medical Park Dr W, Wilson, NC 27893-2705 | 2006-10-17 |
| 1104115211 | Shannon Drohan | Pediatrics | 1702 Medical Park Dr W, Wilson, NC 27893-2878 | 2011-03-30 |
| 1306922562 | Clarissa G Lawrence | Pediatrics | 1702 Medical Park Dr W, Wilson, NC 27893-2705 | 2006-10-31 |
| 1811077209 | John H Buck | Pediatrics | 1702 Medical Park Dr W, Wilson, NC 27893-2705 | 2006-10-17 |
| 1073693347 | Eastern Carolina Pediatrics Pa | Pediatrics | 1702 Medical Park Dr W, Wilson, NC 27893-2705 | 2006-10-17 |
| 1891875340 | Susan H Andersen | Pediatrics | 1702 Medical Park Dr W, Wilson, NC 27893-2705 | 2006-10-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124627146 | Kidzcare Pediatrics, PC | Pediatrics | Kidzcare Pediatrics, PC, 312 South Mccaskey Road, Williamston, NC 27892-2150 | 2020-10-21 |
| 1619582343 | Carolinas Physicians Network Inc | Pediatrics | 9908 Couloak Dr Ste 103, Charlotte, NC 28216-8678 | 2020-09-10 |
| 1992310627 | Carolinas Physicians Network Inc | Pediatrics | 1585 Forney Creek Pkwy Ste 2100, Denver, NC 28037-9520 | 2020-09-10 |
| 1861004426 | Carolinas Physicians Network Inc | Pediatrics | 4501 Cameron Valley Pkwy Ste 200-b, Charlotte, NC 28211-4297 | 2020-08-17 |
| 1871114470 | Kidzcare Pediatrics, PC | Pediatrics | 327 W College Ave, Shelby, NC 28152-8111 | 2020-05-05 |
| 1568082212 | Kidzcare Pediatrics, PC | Pediatrics | 416 Mccullough Dr Ste 140, Charlotte, NC 28262-4390 | 2020-04-23 |
| 1881222404 | Victoria Marie Carvajal | Pediatrics | Cmc/levine's Children's Hospital 1000 Blythe Blvd, 4th Floor, Meb, Charlotte, NC 28203-8812 | 2020-03-30 |
| 1386271930 | Irina Maria Geiculescu | Pediatrics | 1000 Blythe Blvd Fl 4 Meb, Charlotte, NC 28203 | 2020-03-24 |
| 1689201568 | Mark Selna | Pediatrics | 13 Weybridge Pl, Chapel Hill, NC 27517-8938 | 2020-03-23 |
| 1407488349 | Beth A Scisciani | Pediatrics | 8654 Walsham Dr, Charlotte, NC 28277-1850 | 2020-02-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.