Jerome Allen Wisehart

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

2803 Issued in IL

Practice address

1265 S Mill St
Nashville, IL 62263-2004

Phone

(618) 327-4833

NPI assigned

Jul 30, 2006

Last updated

Jul 9, 2007By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1417962226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14940 EAST ST",
            "city": "WHITTINGTON",
            "state": "IL",
            "postal_code": "628971335",
            "telephone_number": "618-629-2585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 S MILL ST",
            "city": "NASHVILLE",
            "state": "IL",
            "postal_code": "622632004",
            "telephone_number": "618-327-4833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEHART",
        "first_name": "JEROME",
        "middle_name": "ALLEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-30",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "IL",
            "license": "2803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270033874009",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270033874011",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Washington County Hospital District (Washington County Hospital)
• Washington County Vocational Workshop
• Harold Whitworth, C.R.N.A.
• Joshua David Wilson, O.D.
• Michael Kenton Wilson, OD
• Bonni S Yaekel

• Hearing Instrument Specialist in Nashville, IL
• Providers in Nashville, IL by specialty
• Hearing Instrument Specialist in Illinois

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

Verify at the official NPI Registry.