Blakely David Wise, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-08866 Issued in NC

Practice address

20036 Zion Ave
Ste 100
Cornelius, NC 28031-8435

Phone

(704) 801-7400

NPI assigned

Feb 19, 2019

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

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Atrium Health North Market Network LLCGroup PAC ID 1557743440, 158 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113
• Atrium Health University City Hospital, Charlotte, NC, CCN 340166

Merit-based Incentive Payment System (MIPS)

Final score

85.41 of 100Reported as group

Quality

77.21

Promoting interoperability

100

Improvement activities

40

Cost

74.17

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bwise411014@carolinashealthcaresystem.direct-ci.com

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.

• Atrium Health North Market Network LLC

  • Family Medicine Physician
  • Mooresville, NC
  • NPI 1871112920
  Medicare reassignment Care Compare group
• Arboretum Urgent Care Center

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1457380313
  Medicare reassignment
• Carolinas Physicians Network Inc

  • Orthopaedic Surgery Physician
  • Charlotte, NC
  • NPI 1437607686
  Medicare reassignment
• Carolinas Physicians Network Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Charlotte, NC
  • NPI 1477878890
  Medicare reassignment
• Carolinas Physicians Network Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Charlotte, NC
  • NPI 1437038544
  NPD
• Carolinas Physicians Network Inc

  • Internal Medicine Physician
  • Huntersville, NC
  • NPI 1730362641
  NPD
• Carolinas Physicians Network Inc

  • Family Medicine Physician
  • Charlotte, NC
  • NPI 1932722980
  NPD
• Field of Dreams PC

  • Specialist
  • Bozeman, MT
  • NPI 1447244140
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Carolinas Medical Center

  • Psychiatric Hospital Unit
  • Charlotte, NC
  • NPI 1053358945
  Care Compare affiliation
• Carolinas Medical Center

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1295789907
  Care Compare affiliation
• Carolinas Medical Center

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1376985135
  Care Compare affiliation
• Carolinas Medical Center

  • Children's Rehabilitation Hospital
  • Charlotte, NC
  • NPI 1699829887
  Care Compare affiliation
• Carolinas Medical Center

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Charlotte, NC
  • NPI 1720029705

  Hospital

  Care Compare affiliation
• Carolinas Medical Center

  • Clinical Medical Laboratory
  • Charlotte, NC
  • NPI 1811005150

  Hospital

  Care Compare affiliation
• The Charlotte-Mecklenburg Hospital Authority

  • General Acute Care Hospital
  • Charlotte, NC
  • NPI 1346297892
  Care Compare affiliation

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

{
    "created_epoch": "1550534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1396201935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20036 ZION AVE",
            "address_2": "STE 100",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280318435",
            "telephone_number": "704-801-7400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Blythe Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035812",
            "country_code": "US",
            "telephone_number": "704-355-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2301 US Highway 74 W",
            "address_purpose": "LOCATION",
            "city": "Wadesboro",
            "state": "NC",
            "postal_code": "281707554",
            "country_code": "US",
            "telephone_number": "704-994-4500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1100 Blythe Blvd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282035814",
            "country_code": "US",
            "telephone_number": "704-355-4300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 E Grover St",
            "address_purpose": "LOCATION",
            "city": "Shelby",
            "state": "NC",
            "postal_code": "281503917",
            "country_code": "US",
            "telephone_number": "980-487-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "BLAKELY",
        "middle_name": "DAVID",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-02-19",
        "last_updated": "2025-09-25",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-08866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bethany Wilson
• Wind and Water, PLLC
• Ryan Winebarger
• Robin Walker Winters, LCMHC
• Christine Ann Wisdom, LPC
• Within U Solutions, LLC
• Wolf Counseling & Clinical Services, PLLC
• Rebecca Wolf, LCMHCA
• McKenzie Wolford, MSW, LCSW
• Kurt Michael Worthmann, DC

• Physician Assistant in Cornelius, NC
• Providers in Cornelius, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.