NPIMap

Individual provider Active NPI

Brittany Dawn Wiseman

  • Physician Assistant
  • Missoula, MT
National Provider Identifier
1174052054
Registry record updated Feb 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-07246 Issued in NC
Practice address
500 W Broadway St
Missoula, MT 59802-4008
Phone
(406) 721-5600
NPI assigned
Jun 5, 2017
Last updated
Feb 3, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2026

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 0010-07246 NC Primary

Addresses

Primary practice location

500 W Broadway St
Missoula, MT 59802-4008

Mailing address

500 W Broadway St
Missoula, MT 59802-4008

Other practice location 1

401 Railroad St W
Missoula, MT 59802-4109
Phone (406) 258-4789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, MT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170901000457 NC Practitioner - Physician Assistant 5698048262 Reassigns benefits to 2 organizations
I20200911002385 MT Practitioner - Physician Assistant 5698048262 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Partnership Health Center IncGroup PAC ID 6103843479, 51 clinicians
Western Montana Clinic PCGroup PAC ID 2466365002, 44 clinicians

Practice addresses (Care Compare)

323 W Alder St
Missoula, MT 59802-4123
Phone (406) 258-4789

500 W Broadway St
Missoula, MT 59802-4008
Phone (406) 721-5600

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Moses H Cone Memorial Hospital Operating Corporation Physician Assistant CurrentSince Feb 10, 2020 Accepting new patients
Partnership Health Center Inc CurrentSince Aug 31, 2020 Accepting new patients
Western Montana Clinic PC Current Accepting new patients
Partnership Health Center Inc CurrentSince Aug 31, 2020 Accepting new patients
Alamance Regional Medical Center, Inc CurrentSince Feb 10, 2020 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Feb 10, 2020 Accepting new patients
Western Montana Clinic PC CurrentSince Nov 1, 2025 Accepting new patients
Western Montana Clinic Past Accepting new patients

Locations

323 W Alder St
Missoula, MT 59802
Phone (406) 258-4195

401 Railroad St W
Missoula, MT 59802
Phone (406) 258-4183

500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918

1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000

102 Pomona Dr
Greensboro, NC 27407
Phone (336) 299-0000

1131 N Church St
Greensboro, NC 27401
Phone (336) 358-5100

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

301 E Wendover Ave
Ste 411
Greensboro, NC 27401
Phone (336) 832-3200

Organizations & group practices 10

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

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": "1496620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770076800000",
    "number": "1174052054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024008",
            "telephone_number": "406-721-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Railroad St W",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598024109",
            "country_code": "US",
            "telephone_number": "406-258-4789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "BRITTANY",
        "middle_name": "DAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-05",
        "last_updated": "2026-02-03",
        "certification_date": "2026-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.