Active NPI
Jon Martin Wiseman, M.D.
- Internal Medicine Physician
- Washington, DC
National Provider Identifier
1316932882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 12890
- Practice address
- 5410 Connecticut Ave NW
Suite 117
Washington, DC 20015-2859 - Phone
- (202) 966-8868
- Fax
- (202) 244-3071
- NPI assigned
- Sep 12, 2005
- Reactivated
- Sep 27, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 12890 | DC | Primary |
Addresses
Primary practice location
5410 Connecticut Ave NW
Suite 117
Washington, DC 20015-2859
Mailing address
5410 Connecticut Ave NW
Suite 117
Washington, DC 20015
Phone (202) 966-8868
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12890 | DC | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 1
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
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1126483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192665600000",
"number": "1316932882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5410 CONNECTICUT AVE NW",
"address_2": "SUITE 117",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "20015",
"telephone_number": "202-966-8868",
"fax_number": "202-244-3071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5410 CONNECTICUT AVE NW",
"address_2": "SUITE 117",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200152859",
"telephone_number": "202-966-8868",
"fax_number": "202-244-3071"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISEMAN",
"first_name": "JON",
"middle_name": "MARTIN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-12",
"last_updated": "2007-10-18",
"deactivation_date": "2006-03-22",
"reactivation_date": "2006-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "DC",
"license": "12890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.