Elizabeth F Wise, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD00019488 Issued in WA

Practice address

521 E Mountain View Ave
Ellensburg, WA 98926-3865

Phone

(509) 962-1414

Fax

(509) 962-1408

NPI assigned

Jun 8, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ewise@kittitasvalleyhealthcare.cernerdirect.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.

• Community Health of Central Washington

  • Federally Qualified Health Center (FQHC)
  • Yakima, WA
  • NPI 1598764920

  Family Medicine

  Medicare reassignment NPD
• Community Health of Central Washington

  • Federally Qualified Health Center (FQHC)
  • Tieton, WA
  • NPI 1700255874
  NPD

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578441600000",
    "number": "1407896111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S 5TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023550",
            "telephone_number": "509-853-1082",
            "fax_number": "509-853-1082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 E MOUNTAIN VIEW AVE",
            "city": "ELLENSBURG",
            "state": "WA",
            "postal_code": "989263865",
            "telephone_number": "509-962-1414",
            "fax_number": "509-962-1408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Alpha Way",
            "address_purpose": "LOCATION",
            "city": "Cle Elum",
            "state": "WA",
            "postal_code": "989221045",
            "country_code": "US",
            "telephone_number": "509-674-5331",
            "fax_number": "509-674-5034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "ELIZABETH",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-08",
        "last_updated": "2020-01-08",
        "certification_date": "2020-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD00019488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8317901",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fritz William Wichterman
• James R Wickerath, M.D.
• Kaitlyn Wilder
• Brian T. Williams, C.P.O., L.P.O.
• Kassondra Lynn Wilson
• Scott Wise, HA 61364303
• Seth Wiswell
• Stacey Wolfe
• Paul David Wood, PA-C
• Taylor Wood

• Family Medicine Physician in Ellensburg, WA
• Providers in Ellensburg, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.