Blake Wiseman, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

05009661A Issued in IN

Practice address

890 E 116TH St
Suite 142
Carmel, IN 46032-3475

Phone

(317) 688-8232

Fax

(866) 512-2250

NPI assigned

Jul 9, 2012

Last updated

Sep 24, 2014By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Priority Rehab LLC

  • Home Health Agency
  • Carmel, IN
  • NPI 1053782631
  NPD Authorized official
• Priority Rehab

  • Physical Therapist
  • Carmel, IN
  • NPI 1407118276
  Authorized official Same address or phone
• Priority Rehab Home Health LLC

  • Home Health Agency
  • Carmel, IN
  • NPI 1093170912
  Authorized official Same address or phone
• Priority Rehab Home Health LLC

  • Home Health Agency
  • Wanatah, IN
  • NPI 1477588507
  NPD (past)
• My Wellness Team LLC

  dba 360 Wellness LLC

  • Physical Therapist
  • Cincinnati, OH
  • NPI 1619651767
  NPD (past)

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411516800000",
    "number": "1508121385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13426 LOST CREEK LN",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460745836",
            "telephone_number": "317-989-3578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "890 E 116TH ST",
            "address_2": "SUITE 142",
            "city": "CARMEL",
            "state": "IN",
            "postal_code": "460323475",
            "telephone_number": "317-688-8232",
            "fax_number": "866-512-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "BLAKE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-09",
        "last_updated": "2014-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05009661A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201186570",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Catherine Winslow, MD
• Kristin Marie Winternheimer, NP-C
• Christopher Winters, DPM
• Peter Lee Winters, M.D.
• Jerry Thomas Wise, MA, MS
• Christopher Wishmire, LCSW
• Thomas Charles Wisler Jr., MD
• Witham Memorial Hospital (Wellbrooke of Carmel)
• Witham Memorial Hospital (McGivney Health Care Center)
• Alyssa Jae Witt, PHARMD

• Physical Therapist in Carmel, IN
• Providers in Carmel, IN by specialty
• Physical Therapist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2014; 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.