Active NPI
Dara J Wise, CTRS
- Recreation Therapist
- Austin, TX
National Provider Identifier
1467066035
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 68853
- Practice address
- 5900 Balcones Dr
Austin, TX 78731-4257 - Phone
- (737) 202-9403
- NPI assigned
- Sep 1, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 68853 | OH | Primary |
Addresses
Primary practice location
5900 Balcones Dr
Austin, TX 78731-4257
Mailing address
5900 Balcones Dr
Austin, TX 78731-4257
Phone (737) 202-9403
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | peacedtogether@peacedtogethertherapies.org | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68853 | OH | MD | Recreation Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peaced Together Therapies LLC | Recreation Therapist | Current | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598918400000",
"number": "1467066035",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5900 BALCONES DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787314257",
"telephone_number": "737-202-9403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 BALCONES DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787314257",
"telephone_number": "737-202-9403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISE",
"first_name": "DARA",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "CTRS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-01",
"last_updated": "2020-09-01",
"certification_date": "2020-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "OH",
"license": "68853",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "peacedtogether@peacedtogethertherapies.org",
"affiliation": "N",
"endpointDescription": "Dara Wise NPI Information",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "5900 Balcones Dr",
"city": "Austin",
"state": "TX",
"country_code": "US",
"postal_code": "787314257",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.