Brian Keith Wise, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

41287 Issued in CO

Practice address

6053 S Quebec St Ste 203
Centennial, CO 80111-4505

Phone

(720) 708-4287

Fax

(720) 815-2581

NPI assigned

Aug 4, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Psychiatry

Education

University of South Carolina School of Medicine, 2000

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: brian.wise.1@20145.direct.athenahealth.com

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

{
    "created_epoch": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728000000000",
    "number": "1043211683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6053 S QUEBEC ST STE 203",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801114505",
            "telephone_number": "720-708-4287",
            "fax_number": "720-815-2581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6053 S QUEBEC ST STE 203",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801114505",
            "telephone_number": "720-708-4287",
            "fax_number": "720-815-2581"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "720 S Colorado Blvd Ph North",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802461904",
            "country_code": "US",
            "telephone_number": "303-219-0030",
            "fax_number": "303-600-7340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "BRIAN",
        "middle_name": "KEITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-04",
        "last_updated": "2024-10-04",
        "certification_date": "2024-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CO",
            "license": "41287",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "41287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "C811544",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1043211683",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70583072",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "C802299",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "billing@wisepsych.com",
            "affiliation": "N",
            "address_1": "6053 S Quebec St Ste 203",
            "city": "Centennial",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801114505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patricia Ann Winkler, P.T.
• Mary Winn
• Carolyn C Winterbottom
• Joshua Paul Wintje, MD
• Wise Psychiatry, PC
• Patricia Lynn Wismann-Horther, M.A.
• Nicholas Guy Wismann, LAC, LMP
• Natalie Elaine Wittstruck, MA, MFTC
• Elizabeth Cathleen Wolf, LCSW
• Katherine Keegan Wolf, LCSW

• Psychiatry Physician in Centennial, CO
• Providers in Centennial, CO by specialty
• Psychiatry Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.