Individual provider Active NPI

Ian Wissinger, RN

  • Medical-Surgical Registered Nurse
  • Altoona, PA
National Provider Identifier
1073278396
Registry record updated Nov 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical-Surgical Registered NurseTaxonomy code 163WM0705X
License
RN670654 Issued in PA
Practice address
2907 Pleasant Valley Blvd
Altoona, PA 16602-4305
Phone
(877) 626-2500
NPI assigned
Nov 2, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X RN670654 PA Primary

Addresses

Primary practice location

2907 Pleasant Valley Blvd
Altoona, PA 16602-4305

Mailing address

1115 Norway Ave
Altoona, PA 16602-4041
Phone (814) 414-8344

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN670654PAMDMedical-Surgical Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1635811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635811200000",
    "number": "1073278396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1115 NORWAY AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166024041",
            "telephone_number": "814-414-8344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2907 PLEASANT VALLEY BLVD",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166024305",
            "telephone_number": "877-626-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISSINGER",
        "first_name": "IAN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-02",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "PA",
            "license": "RN670654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; 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.