Teresa a. Wise, O.D., P.S.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

1156DT Issued in KY

Legal business name

TERESA A. WISE, O.D., P.S.C.

Practice address

2904 Dolphin Dr
Elizabethtown, KY 42701-7102

Phone

(270) 769-3708

Fax

(270) 765-2043

NPI assigned

Jul 15, 2008

Organization subpart

No

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

Authorized official

Name

Teresa Ann Wise, O.D.

Title

President

Phone

(270) 769-3708

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Wise Vision Care Doing business as

Locations

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216080000000",
    "number": "1063676443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2904 DOLPHIN DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427017102",
            "telephone_number": "270-769-3708",
            "fax_number": "270-765-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2904 DOLPHIN DR",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427017102",
            "telephone_number": "270-769-3708",
            "fax_number": "270-765-2043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TERESA A. WISE, O.D., P.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-15",
        "last_updated": "2008-07-15",
        "status": "A",
        "authorized_official_last_name": "WISE",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "270-769-3708",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "KY",
            "license": "1156DT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "770011567",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wise Vision Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Margaret Taylor
• Rachel Taylor, DNP, APRN, FNP-BC
• Thomas Taylor, M.D.
• Kelly Dawn Tedford, APSS
• Tender Touch Senior Services, Inc.
• Brittany Elaine Terregrossa, APSS
• Mackenzie Rachel Terrell
• Dawn Terrigino
• David Neal Terry, LCADC
• James Bennett Terry

• Optometrist in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Optometrist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.