Active NPI
Mary A Wheeler, PA
- Physician Assistant
- Racine, WI
National Provider Identifier
1205809753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 1809
- Practice address
- 1320 Wisconsin Ave
Racine, WI 53403-1978 - Phone
- (262) 687-2222
- Fax
- (262) 687-2495
- NPI assigned
- Feb 7, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1809 | WI | Primary |
Addresses
Primary practice location
1320 Wisconsin Ave
Racine, WI 53403-1978
Mailing address
1320 Wisconsin Ave
Racine, WI 53403-1978
Phone (262) 687-2222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 704290 | Medicaid | AZ |
Other names 1
- Mare A Wheeler
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psych Recovery Inc | Past | Accepting new patients | |
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Psychiatric Recovery PA | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
-
- Psychiatry Physician
- Saint Paul, MN
- NPI 1316189541
-
- Adolescent and Children Mental Health Clinic/Center
- Saint Paul, MN
- NPI 1891713681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139270400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522281600000",
"number": "1205809753",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1320 WISCONSIN AVE",
"city": "RACINE",
"state": "WI",
"postal_code": "534031978",
"telephone_number": "262-687-2222",
"fax_number": "262-687-2495"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1320 WISCONSIN AVE",
"city": "RACINE",
"state": "WI",
"postal_code": "534031978",
"telephone_number": "262-687-2222",
"fax_number": "262-687-2495"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHEELER",
"first_name": "MARY",
"middle_name": "A",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-07",
"last_updated": "2018-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "1809",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "704290",
"state": "AZ"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MARE",
"last_name": "WHEELER",
"middle_name": "A",
"credential": "PAC",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Racine, WI
- Wheaton Franciscan Healthcare-All Saints
- Wheaton Franciscan Healthcare-All Saints Foundation Inc
- Wheaton Franciscan Healthcare-All Saints, Inc
- Wheaton Franciscan Healthcare-All Saints, Inc.
- Wheaton Franciscan Hospital
- Hollie White, APSW
- Mary Jane Whitmore, LCSW, CADCIII
- Alyson Gail Wiedenbeck, CCC-SLP
- Margaret Jean Wiesner, PHARMD
- William A. Wilke, LCSW, SAC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.