Wise Family Eye Center, LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

MA72455 Issued in NJ

Legal business name

WISE FAMILY EYE CENTER, LLC

Practice address

54 W Jimmie Leeds Rd Unit 15
Galloway, NJ 08205-9401

Phone

(609) 652-1010

NPI assigned

Jun 4, 2007

Last updated

Jan 3, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Richard Bryan Wise, M.D.NPI 1619971520

Title

Owner

Phone

(609) 652-1010

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Richard B Wise, M.D.

  • Ophthalmology Physician
  • Galloway, NJ
  • NPI 1619971520
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199318400000",
    "number": "1457553026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 W JIMMIE LEEDS RD UNIT 15",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059401",
            "telephone_number": "609-652-1010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 W JIMMIE LEEDS RD UNIT 15",
            "city": "GALLOWAY",
            "state": "NJ",
            "postal_code": "082059401",
            "telephone_number": "609-652-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE FAMILY EYE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2008-01-03",
        "status": "A",
        "authorized_official_last_name": "WISE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-652-1010",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "MA72455",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH",
            "identifier": "2398350000",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON MERCY",
            "identifier": "60000622",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3840133",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8640408",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Williamson, DPM
• Barbara Finegan Wilson, LCSW
• Corynne Wilson, LPC
• Kelsey Ann Wilson
• Candace Kay Winkel
• Richard B Wise, M.D.
• Lussienne Wisniewski, M.D.
• Robyn E Wood, MSW,LCADC
• Woodbine Senior Living, LLC
• Kathrine Anne Woodfall, LCSW

• Ophthalmology Physician in Galloway, NJ
• Providers in Galloway, NJ by specialty
• Ophthalmology Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.