Mary Elizabeth Wise, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN213344 Issued in GA

Practice address

496 Fairfield CT
Evans, GA 30809-3641

Phone

(229) 292-9248

NPI assigned

Jan 21, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1390262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1184047565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3647 J DEWEY GRAY CIR STE 200",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309092205",
            "telephone_number": "706-504-9712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "496 FAIRFIELD CT",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093641",
            "telephone_number": "229-292-9248"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3647 J Dewey Gray Cir Ste 200",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "309092205",
            "country_code": "US",
            "telephone_number": "706-504-9712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-21",
        "last_updated": "2022-01-04",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN213344",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN213344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MARY.WISE@hca5.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "3647 J Dewey Gray Cir Ste 200",
            "city": "Augusta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "309092205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Yulanda Williams, EDD, LPC, NCC, CRC
• Ammy Wilson-Rivera, BCBA
• Courtney Wimberly
• Melvin Leonard Wimmer III, PT, DPT
• Wind and Willow
• Mykel Wise, RBT
• Mark Everett Wittmer, M.D.
• Women'S Massage Center
• Women'S Physical Therapy of Evans,Inc.
• Sally Edwards Wood, RN, IBCLC

• Nurse Practitioner in Evans, GA
• Providers in Evans, GA by specialty
• Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.