Individual provider Active NPI

Robert Michael Wiseman, MD

  • Gastroenterology Physician
  • Morristown, TN
National Provider Identifier
1487737748
Registry record updated May 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD019682 Issued in TN
Practice address
615 West Seventh North St
Morristown, TN 37814
Phone
(423) 581-1000
Fax
(423) 581-1399
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X MD019682 TN Primary

Addresses

Primary practice location

615 West Seventh North St
Morristown, TN 37814

Mailing address

615 West Seventh North St
Morristown, TN 37814
Phone (423) 581-1000

Other identifiers 1

IdentifierTypeStateIssuer
92796OtherTNBCBS OF TN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111118000392 TN Practitioner - Gastroenterology 4183898687 Practice locations: Morristown, TN

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD019682TNMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arvinder J Sachdev MD PC Gastroenterology PastSince Apr 1, 2016 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": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304380800000",
    "number": "1487737748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 WEST SEVENTH NORTH ST",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "37814",
            "telephone_number": "423-581-1000",
            "fax_number": "423-581-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 WEST SEVENTH NORTH ST",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "37814",
            "telephone_number": "423-581-1000",
            "fax_number": "423-581-1399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "ROBERT",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2011-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TN",
            "license": "MD019682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "92796",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, TN

Sources for this page

Verify at the official NPI Registry.