W. Robert Wisman MD PC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

0101014128 Issued in VA

Legal business name

W. ROBERT WISMAN MD PC

Practice address

1506 Franklin Rd SW
Roanoke, VA 24016-5207

Phone

(540) 345-8124

Fax

(540) 345-3423

NPI assigned

Jun 30, 2010

Organization subpart

No

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

Authorized official

Name

Dr. W Robert Wisman, MD

Title

Physician

Phone

(540) 345-8124

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1277856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1278633600000",
    "number": "1316258791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240165207",
            "telephone_number": "540-345-8124",
            "fax_number": "540-345-3423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 FRANKLIN RD SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240165207",
            "telephone_number": "540-345-8124",
            "fax_number": "540-345-3423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W. ROBERT WISMAN MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-30",
        "last_updated": "2010-07-09",
        "status": "A",
        "authorized_official_last_name": "WISMAN",
        "authorized_official_first_name": "W",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "540-345-8124",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "VA",
            "license": "0101014128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006228623",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jay Shailesh Vora, DO
• Thuy My Vu, MS, CGC
• VV Roanoke, LLC (Vital Care of Roanoke, VA)
• Chiraag Vyas, MD
• W. Hampton Pasley, M.D., PLC (Pasley Surgical)
• Barryton Decruse Waanbah, M.D.
• Christopher Paul Waasdorp Jr., D.O.
• Ilana Nicole Kellogg Waasdorp, PT, DPT
• Anna Lindsey Cummings Wade, MS, LPC, NCC
• Kayla Wade, CRNA

• Medical Specialty Clinic/Center in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Medical Specialty Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.