DR. KELVIN JAMES WILEY (NPI# 1194810481) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194810481 |
| Entity Type | Individual |
| Full Name | DR. KELVIN JAMES WILEY |
| Credential | M.D. |
| Practice Address |
4201 Belfort Rd Jacksonville FL 32216-1431 |
| Mailing Address |
1650 Margaret St Ste 302 Jacksonville FL 32204-3868 |
| Practice Telephone | 8037186251 |
| Mailing Telephone | 8037186251 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2016-04-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 23431 | SC | Other Service Providers |
| N | 207R00000X | Internal Medicine | ME111390 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 234311 | 05 |
| Street Address |
4201 BELFORT RD |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32216-1431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205823267 | Michael Gordon Maxwell | Emergency Medicine | 4201 Belfort Rd, Jacksonville, FL 32216-1431 | 2005-10-04 |
| 1285247411 | Victoria Potts | Anesthesiologist Assistant | 4201 Belfort Rd, Jacksonville, FL 32216-1431 | 2020-08-27 |
| 1003442005 | Yu-chun Li | Nurse Practitioner | 4201 Belfort Rd, Jacksonville, FL 32216-1431 | 2020-03-21 |
| 1265963680 | Tanner Miles | Emergency Medicine | 4201 Belfort Rd, Jacksonville, FL 32216-1431 | 2017-03-27 |
| 1437522638 | Shela Towanna Mainor | Physician Assistant | 4201 Belfort Rd, St. Vincent's Medical Center Southside, Jacksonville, FL 32216-1431 | 2015-11-10 |
| 1275914269 | Neonila Zhukivskyy | Internal Medicine | 4201 Belfort Rd, Jacksonville, FL 32216-1431 | 2015-06-15 |
| 1689063406 | Elite Hospitalist Group | Internal Medicine | 4201 Belfort Rd, Jacksonville, FL 32216-1431 | 2015-01-16 |
| 1689929903 | Lorilee Olmoguez | Pharmacist | 4201 Belfort Rd, Jacksonville, FL 32216-1431 | 2012-07-24 |
| 1518212547 | Happy Farouk Sadiek | Internal Medicine | 4201 Belfort Rd, Jacksonville, FL 32216-1431 | 2012-07-16 |
| 1285991802 | Kimberlie Stickney | Physician Assistant | 4201 Belfort Rd, Jacksonville, FL 32216-1431 | 2012-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524925 | Renee Cherie Titus | Behavior Technician | Growing Together Center 6789 Southpoint Parkway, Building 100, Jacksonville, FL 32216 | 2020-09-24 |
| 1811546575 | First Coast Orthopedic Center, LLC | Clinic/Center | 4035 Southpoint Boulevard, Jacksonville, FL 32216 | 2019-09-05 |
| 1922578558 | Fatima Hussain Crofton | Optometrist | 7051 Southpoint Parkway S 300, Jacksonville, FL 32216 | 2018-11-27 |
| 1154802833 | John-paul Pham | Internal Medicine | 4141 Southpoint Drive East, Suite D, Jacksonville, FL 32216 | 2018-08-22 |
| 1790279479 | Joseph Richard Kennedy | Physician Assistant | 6650 Corporate Center Pkwy Apt 1604, Jacksonville, FL 32216 | 2018-06-18 |
| 1801304357 | Kelli M. Tyson | Nurse Practitioner | 3550 University Blvd. S., Ste 302, Jacksonville, FL 32216 | 2018-01-18 |
| 1376054809 | Angela M Whittinghill | Counselor | 8833 Perimeter Park Blvd #702, Jacksonville, FL 32216 | 2017-10-24 |
| 1629508072 | Zoryana Yufan | Dentist | 8750 Perimeter Park Blvd Ste 101, Jacksonville, FL 32216 | 2017-06-19 |
| 1700318896 | Christina Kaczmarek | Behavior Technician | 6816 Southpoint Pkwy Ste 500, Jacksonville, FL 32216 | 2017-03-29 |
| 1932640422 | Loudine Racius | Nurse Practitioner | 8539 Gate Parkway W, Unit 1422, Jacksonville, FL 32216 | 2017-03-16 |
| Find all providers in zip 32216 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437768033 | Coastal Injury Clinic LLC | Specialist | 2700 Riverside Ave Ste 1, Jacksonville, FL 32205-8233 | 2020-07-29 |
| 1255957643 | Rhonda D Smith Roberts | Specialist | 2754 Sam Hardwick Blvd, Jacksonville, FL 32246-3892 | 2020-06-22 |
| 1437620986 | Nicole Azaan | Specialist | 2301 Indian Dr Apt 29c, Jacksonville, NC 28546-5258 | 2018-12-10 |
| 1598251910 | Allionz LLC | Specialist | 2386 Dunn Ave Ste 109, Jacksonville, FL 32218-4751 | 2018-07-09 |
| 1093236531 | Leah F Friedman | Specialist | 1650 Prudential Dr Ste 102, Jacksonville, FL 32207-8148 | 2017-07-06 |
| 1609301993 | Oakleaf Injury and Pain Center LLC | Specialist | 9526 Argyle Forest Blvd, B-6, Jacksonville, FL 32222-2825 | 2017-04-25 |
| 1982070140 | Riverside Spine & Pain Physicians, LLC | Specialist | 13133 Professional Dr, Suite 200, Jacksonville, FL 32225-7122 | 2015-08-11 |
| 1235525239 | Elizabeth Wehr | Specialist | 319 1st Ave N Apt 1a, Jacksonville, FL 32250-5500 | 2015-04-07 |
| 1053705236 | Orthowilmington, Pa | Specialist | 3382 Henderson Dr, Jacksonville, NC 28546-5230 | 2015-03-25 |
| 1295156941 | Southeast Orthopedic Specialists, Inc. | Specialist | 10475 Centurion Pkwy N Ste 220, Jacksonville, FL 32256-5004 | 2013-12-26 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32216 |
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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.