Individual provider Active NPI

Chloe Wise, PA-C

  • Physician Assistant
  • Springfield, OH
National Provider Identifier
1134980113
Registry record updated Apr 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.008551RX Issued in OH
Practice address
1108 Vester Ave
Springfield, OH 45503-1302
Phone
(937) 399-7100
Fax
(937) 399-7355
NPI assigned
Jan 17, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.008551RX OH Primary

Addresses

Primary practice location

1108 Vester Ave
Springfield, OH 45503-1302

Mailing address

1211 1/2 Harrison Ave
Columbus, OH 43201-3113
Phone (330) 842-3283

Other practice location 1

1211 1/2 Harrison Ave
Columbus, OH 43201-3113
Phone (330) 842-3283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240411002450 OH Practitioner - Physician Assistant 2466891387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Health Physicians Springfield Specialty Care LLCGroup PAC ID 4284059981, 129 clinicians

Practice addresses (Care Compare)

1108 Vester Ave
Springfield, OH 45503-1302
Phone (937) 339-7100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.008551RXOHMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: cwise2550713@direct.bsmhealth.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1705449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713744000000",
    "number": "1134980113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 1/2 HARRISON AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432013113",
            "telephone_number": "330-842-3283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 VESTER AVE",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "455031302",
            "telephone_number": "937-399-7100",
            "fax_number": "937-399-7355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1211 1/2 Harrison Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432013113",
            "country_code": "US",
            "telephone_number": "330-842-3283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "CHLOE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-17",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.008551RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OH

Sources for this page

Verify at the official NPI Registry.