Individual provider Active NPI

Monica Wise, ARNP

  • Family Nurse Practitioner
  • Melbourne, FL
National Provider Identifier
1437324670
Registry record updated Feb 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP3329362 Issued in FL
Practice address
675 S Babcock St
Melbourne, FL 32901
Phone
(321) 951-1010
Fax
(321) 952-4038
NPI assigned
Apr 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP3329362 FL Primary

Addresses

Primary practice location

675 S Babcock St
Melbourne, FL 32901

Mailing address

675 S Babcock St
Melbourne, FL 32901-1459
Phone (321) 951-1010

Other practice location 1

1350 S Hickory St
Suite 103
Melbourne, FL 32901-3224
Phone (321) 434-1735

Other identifiers 3

IdentifierTypeStateIssuer
9592477OtherFLAETNA
P00798086OtherFLRR MEDICARE
Y01MTOtherFLFLORIDA BLUE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20080702000033 FL Practitioner - Nurse Practitioner 3870665177 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP3329362FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Minuteclinic LLC Family CurrentSince Apr 8, 2008 Accepting new patients
Primary Care Solutions & More LLC CurrentSince Aug 29, 2022 Accepting new patients
Brevard Physician Associates, PLLC CurrentSince Feb 1, 2015 Accepting new patients

Locations

121 W Macclenny Ave
Macclenny, FL 32063
Phone (904) 259-6380

1350 Hickory St
Ste 103
Melbourne, FL 32901
Phone (321) 434-1735

1350 Hickory St
Melbourne, FL 32901
Phone (321) 434-1771

12401 Miramar Pkwy
Miramar, FL 33027
Phone (954) 538-8473

8765 S Dixie Hwy
Pinecrest, FL 33156
Phone (305) 740-6840

1701 SE Hillmoor Dr
Ste 7
Port St Lucie, FL 34952
Phone (772) 398-9808

7599 W Sand Lake Rd
Sand Lake, FL 32819
Phone (407) 352-0943

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550448000000",
    "number": "1437324670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 S BABCOCK ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329011459",
            "telephone_number": "321-951-1010",
            "fax_number": "321-951-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 S BABCOCK ST",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "32901",
            "telephone_number": "321-951-1010",
            "fax_number": "321-952-4038"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1350 S Hickory St",
            "address_2": "Suite 103",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "329013224",
            "country_code": "US",
            "telephone_number": "321-434-1735",
            "fax_number": "321-434-1796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "MONICA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-29",
        "last_updated": "2019-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP3329362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9592477",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00798086",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "Y01MT",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.