Organization Active NPI

Wisdo Family Medicine, James John Wisdo DO PA

  • Family Medicine Physician
  • Ocala, FL
National Provider Identifier
1053458455
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WISDO FAMILY MEDICINE, JAMES JOHN WISDO DO PA
Practice address
2685 SW 32ND PL Ste 500
Ocala, FL 34471-7867
Phone
(352) 622-9007
Fax
(352) 622-2179
NPI assigned
Feb 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Authorized official

Name
Janice E Medley
Title
Office Manager
Phone
(352) 622-9007

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X FL Primary

Addresses

Primary practice location

2685 SW 32ND PL Ste 500
Ocala, FL 34471-7867

Mailing address

2685 SW 32ND PL Ste 500
Ocala, FL 34471-7867
Phone (352) 622-9007

Other identifiers 1

IdentifierTypeStateIssuer
253125900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041112000137 FL Part B Supplier - Clinic/Group Practice 1456315282 Receives reassigned benefits from 2 practitioners
Practice locations: Ocala, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1032063Wisdo Family Medicine2685 SW 32ND PL Suite 500, Ocala, FL 34471Certificate of waiverJun 16, 2027

National Provider Directory

National Provider Directory

Locations

200 SE 17th St
Ste A
Ocala, FL 34471
Phone (352) 622-9007

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595289600000",
    "number": "1053458455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2685 SW 32ND PL STE 500",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344717867",
            "telephone_number": "352-622-9007",
            "fax_number": "352-622-2179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2685 SW 32ND PL STE 500",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344717867",
            "telephone_number": "352-622-9007",
            "fax_number": "352-622-2179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISDO FAMILY MEDICINE, JAMES JOHN WISDO DO PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-01",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A",
        "authorized_official_last_name": "MEDLEY",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "352-622-9007"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "253125900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.