Active NPI
Healthwise Medical Clinic PLLC
- Family Nurse Practitioner
- Alpena, MI
National Provider Identifier
1154416717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704177958
- Legal business name
- HEALTHWISE MEDICAL CLINIC PLLC
- Practice address
- 101 Oxbow Drive
Healthwise Medical Clinic
Alpena, MI 49707 - Phone
- (989) 358-8100
- Fax
- (989) 354-4979
- NPI assigned
- Oct 3, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rhonda S Keller, FNP
- Title
- Owner
- Phone
- (989) 358-8100
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704177958 | MI | Primary |
| Family Nurse Practitioner | 363LF0000X | 4704208256 | MI |
Addresses
Primary practice location
101 Oxbow Drive
Healthwise Medical Clinic
Alpena, MI 49707
Mailing address
101 Oxbow Drive
1
Alpena, MI 49707
Phone (989) 358-8100
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4975205 | Medicaid | MI | |
| 49775199 | Medicaid | MI | |
| 500Z410370 | Other | BCBS |
National Provider Directory
National Provider DirectoryLocations
101 Oxbow Dr
#1
Alpena, MI 49707
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CAFCDA
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1466640000000",
"number": "1154416717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 OXBOW DRIVE",
"address_2": "1",
"city": "ALPENA",
"state": "MI",
"postal_code": "49707",
"telephone_number": "989-358-8100",
"fax_number": "989-354-4979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 OXBOW DRIVE",
"address_2": "HEALTHWISE MEDICAL CLINIC",
"city": "ALPENA",
"state": "MI",
"postal_code": "49707",
"telephone_number": "989-358-8100",
"fax_number": "989-354-4979"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEALTHWISE MEDICAL CLINIC PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2006-10-03",
"last_updated": "2016-06-23",
"status": "A",
"authorized_official_last_name": "KELLER",
"authorized_official_first_name": "RHONDA",
"authorized_official_middle_name": "S",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "989-358-8100",
"authorized_official_credential": "FNP"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704177958",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704208256",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4975205",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "49775199",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "500Z410370",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Alpena, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.