Mark Wise, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY000818 Issued in GA

Practice address

3000 Schatulga Rd BLDG 5
Columbus, GA 31907-3117

Phone

(706) 568-5216

Fax

(706) 562-1484

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

Yes

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

Practice roles

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.

• Ameripartner Inc.

  • Clinical Psychologist
  • Dalton, GA
  • NPI 1023067626
  NPD (past)
• Georgia Department of Human Resources

  dba West Central Georgia Regional Hospital

  • Psychiatric Hospital
  • Columbus, GA
  • NPI 1144224767
  NPD (past)

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477645471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4989 POST ROAD PASS",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300882007",
            "telephone_number": "770-469-6754",
            "fax_number": "770-498-4738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 SCHATULGA RD BLDG 5",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319073117",
            "telephone_number": "706-568-5216",
            "fax_number": "706-562-1484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "GA",
            "license": "PSY000818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Winship Clinic,P.C.
• Andrea Winston, LPC
• Kacey Winston
• Roderick Winston
• Carlos Rodriguez Wise, MD
• Trawick Smith Wise, CCC-SLP
• Danielle Wiseley, PA-C
• With Open Arms Private Home Care
• With Woman Care and Consultants, LLC
• Jessica Lynn Withey, MD

• Clinical Psychologist in Columbus, GA
• Providers in Columbus, GA by specialty
• Clinical Psychologist in Georgia

• 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.