Individual provider Active NPI

Gregory R Wise, MD

  • Internal Medicine Physician
  • Miamisburg, OH
National Provider Identifier
1184605263
Registry record updated Apr 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35 072143 Issued in OH
Practice address
2115 Leiter Rd
Miamisburg, OH 45342-3659
Phone
(937) 384-6800
Fax
(937) 384-6939
NPI assigned
Nov 7, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G28815 CA
Internal Medicine Physician 207R00000X 35 072143 OH Primary

Addresses

Primary practice location

2115 Leiter Rd
Miamisburg, OH 45342-3659

Mailing address

2115 Leiter Rd
Miamisburg, OH 45342-3600
Phone (937) 384-6800

Other identifiers 1

IdentifierTypeStateIssuer
2033150MedicaidOH

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address gwise2063@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100215000572 OH Practitioner - Internal Medicine 4385540970 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Loma Linda University School of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Physicians IncGroup PAC ID 0840104360, 314 clinicians

Practice addresses (Care Compare)

2115 Leiter Rd
Miamisburg, OH 45342-3600
Phone (937) 384-6920

Merit-based Incentive Payment System (MIPS)

Final score
84.8 of 100Reported as group
Quality
73.21
Promoting interoperability
100
Improvement activities
40
Cost
76.12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G28815CAMDInternal Medicine Physician
35 072143OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Alliance Physicians Inc Internal Medicine CurrentSince Mar 3, 2011 Accepting new patients
Greene Memorial Hospital Services, Inc. PastSince Nov 1, 2012 Accepting new patients

Locations

7740 Washington Village Dr
Ste 130
Dayton, OH 45459
Phone (513) 932-4891

2115 Leiter Rd
Ste 300
Miamisburg, OH 45342

2115 Leiter Rd
Miamisburg, OH 45342
Phone (937) 384-6920

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744675200000",
    "number": "1184605263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 LEITER RD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423600",
            "telephone_number": "937-384-6800",
            "fax_number": "937-384-6938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 LEITER RD",
            "city": "MIAMISBURG",
            "state": "OH",
            "postal_code": "453423659",
            "telephone_number": "937-384-6800",
            "fax_number": "937-384-6939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "GREGORY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2025-04-15",
        "certification_date": "2025-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G28815",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35 072143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2033150",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gwise2063@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "2115 Leiter Rd",
            "city": "Miamisburg",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453423659",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2115 Leiter Rd",
            "city": "Miamisburg",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453423659",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miamisburg, OH

Sources for this page

Verify at the official NPI Registry.