Ross Davin Wise, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN11042360 Issued in FL

Practice address

1896 S 14TH St Ste 6
Fernandina Beach, FL 32034-4416

Phone

(904) 310-9652

Fax

(904) 467-3143

NPI assigned

Sep 19, 2025

Last updated

Sep 19, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Amelia Behavioral Wellness LLC

  • Clinical Psychologist
  • Fernandina Beach, FL
  • NPI 1053944330
  NPD

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

{
    "created_epoch": "1758240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1194697284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 BLUE DAZE ST",
            "city": "YULEE",
            "state": "FL",
            "postal_code": "320970087",
            "telephone_number": "904-310-9652",
            "fax_number": "904-467-3143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1896 S 14TH ST STE 6",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320344416",
            "telephone_number": "904-310-9652",
            "fax_number": "904-467-3143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "ROSS",
        "middle_name": "DAVIN",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-09-19",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN11042360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kedra Fields Williams, M.D.
• Tyler Andrew Wills, OD
• Rosemary T Wilson, APRN
• Shelly Fulford Wilson, LCSW
• Amir Wind, MD
• Women's Care Florida LLC
• Alana Woods, LCSW
• Kathryn Worley, LMFT
• Robert Thomas Wulterkens
• Yash P Sangwan M D P a

• Psychiatric/Mental Health Nurse Practitioner in Fernandina Beach, FL
• Providers in Fernandina Beach, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.