Wisemind Wellness, LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

WISEMIND WELLNESS, LLC

Practice address

20 E Thomas Rd Ste 2200
Phoenix, AZ 85012-3133

Phone

(541) 990-2613

NPI assigned

Feb 12, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Nathan Dingeldein, PMHNP, BC

Title

Psychiatric Nurse Practitioner

Phone

(541) 990-2613

Specialties & licenses 2

Addresses

Other identifiers 1

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

{
    "created_epoch": "1613088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617580800000",
    "number": "1265025050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 33784",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850673784",
            "telephone_number": "480-359-5816",
            "fax_number": "833-520-1481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 E THOMAS RD STE 2200",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850123133",
            "telephone_number": "541-990-2613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISEMIND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-12",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A",
        "authorized_official_last_name": "DINGELDEIN",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "PSYCHIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "541-990-2613",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PMHNP, BC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "632705",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen Wise, RN
• Kelly Wise
• Tamara Noel Wisely, WHNP
• Anthony M Wiseman, PHARM.D.
• Jason T. Wiseman, MD, MSPH
• Amber Wiser, PT, ATC
• Fidaa J M Wishah, M.D
• David Wisinger, MD
• Linda Wiskerchen, COUNSELOR
• Rebecca Renee Wiskirchen

• Mental Health Clinic/Center (Including Community Mental Health Center) in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; 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.