Neil Kent Wise, MD

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

036050195 Issued in IL

Practice address

5405 N Knoxville Ave
Peoria, IL 61614

Phone

(309) 691-4410

Fax

(309) 589-2830

NPI assigned

Jul 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Heartcare Midwest

  • Rural Acute Care Hospital
  • Bloomington, IL
  • NPI 1477782845
  NPD (past)
• Heartcare Midwest , LTD

  • Cardiovascular Disease Physician
  • Peoria, IL
  • NPI 1720023179
  NPD (past)
• St Joseph Medical Center

  • Family Medicine Physician
  • Bloomington, IL
  • NPI 1871547414
  NPD (past)

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1164456463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5405 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61614",
            "telephone_number": "309-691-4410",
            "fax_number": "309-589-2830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61614",
            "telephone_number": "309-691-4410",
            "fax_number": "309-589-2830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "NEIL",
        "middle_name": "KENT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036050195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036050195",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin M Winn, SPEECH/LANG
• Victoria Winn, ST
• Kelly A Winters, ATC
• Earl J Wipfler, M.D.
• Joyce Wise, MD
• Norma A. Wiser, R.D.
• With All Your Art Therapy, LLC
• Julie Anne Witkowski, LCPC
• Alex Woehlke, D.O.
• Yvonne Wojtalik, LCPC

• Cardiovascular Disease Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Cardiovascular Disease Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; 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.