A Michelle Wise, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2787 Issued in SC

Practice address

739 Galleria Blvd Ste 112
Rock Hill, SC 29730-5785

Phone

(803) 547-4343

NPI assigned

Mar 16, 2009

Sex

Female

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

Other names 1

• A. Michelle Wise-Eastergard Professional name

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Spartanburg Medical Center

  • Neuromusculoskeletal Medicine & OMM Physician
  • Spartanburg, SC
  • NPI 1043309917
  Medicare reassignment NPD
• Intramed Plus Infusion & Medical Center, LLC

  • Clinic/Center
  • West Columbia, SC
  • NPI 1063053833
  NPD
• Spartanburg Medical Center

  • Family Medicine Physician
  • Spartanburg, SC
  • NPI 1326373697
  NPD
• Spartanburg Medical Center

  • Physical Medicine & Rehabilitation Physician
  • Spartanburg, SC
  • NPI 1942188875
  NPD
• Infinite Wellness Center

  • Internal Medicine Physician
  • Fort Mill, SC
  • NPI 1962772764
  NPD (past)
• New Horizon Family Health Services Inc

  • Federally Qualified Health Center (FQHC)
  • Greenville, SC
  • NPI 1629872734
  NPD (past)

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

{
    "created_epoch": "1237161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543536000000",
    "number": "1164663449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 AVERY JONES LN APT 202",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297300155",
            "telephone_number": "864-501-7603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 GALLERIA BLVD STE 112",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297305785",
            "telephone_number": "803-547-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "A",
        "middle_name": "MICHELLE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-16",
        "last_updated": "2018-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "2787",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "SCC1783365",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "A. MICHELLE",
            "last_name": "WISE-EASTERGARD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Amy Elizabeth Winters, MS, LPC
• Winthrop University
• Winthrop University Health Services Pharmacy
• Wise Medical Staffing
• Wise Resources
• Stacy Johnson Wiseman, RD, LDN
• Jade Witmer, ATC
• Kaitlyn Wojdat, DPT
• Benjamin Wood
• Lawrence Robert Wood, APRN-BC

• Family Nurse Practitioner in Rock Hill, SC
• Providers in Rock Hill, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.