Matthew John Wise, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2004017456 Issued in MO

Practice address

190 Spring Dr
Saint Charles, MO 63303-3255

Phone

(636) 946-0799

Fax

(314) 205-1508

NPI assigned

Jan 3, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Allied Physicians Group LLC

  • Specialist
  • Springfield, MO
  • NPI 1295937423
  NPD (past)
• Allied Physicians Group LLC

  • Chiropractor
  • Town & Country, MO
  • NPI 1326130345
  NPD (past)
• Goforth Health Center, LLC

  • Health Service Clinic/Center
  • Osage Beach, MO
  • NPI 1114347705
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477600641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14324 S OUTER 40",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175710",
            "telephone_number": "314-208-8858",
            "fax_number": "314-205-1508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 SPRING DR",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633033255",
            "telephone_number": "636-946-0799",
            "fax_number": "314-205-1508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "MATTHEW",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2004017456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cherice Wings
• Jessalyn Wininger, LPC
• Theresa Ann Winkler
• Aaron Rey Winston, PA-C
• Renee Lynn Wisdom, LPC
• Nancy L Wiseman, L.C.S.W.
• Barri Wishne, LCSW
• Loralee J Wold, MD
• Danielle Wolfe
• Michelle L Wolynski, NP

• All providers in Saint Charles, MO
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.