Individual provider Active NPI

Philip Wiseman

  • Audiologist-Hearing Aid Fitter
  • Minot, ND
National Provider Identifier
1508219775
Registry record updated Jul 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
1516 Issued in ND
Practice address
1400 37TH Ave SW
Minot, ND 58701-7339
Phone
(701) 852-6565
NPI assigned
Jul 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 1516 ND Primary

Addresses

Primary practice location

1400 37TH Ave SW
Minot, ND 58701-7339

Mailing address

1400 37TH Ave SW
Minot, ND 58701-7339
Phone (701) 852-6565

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
1516NDMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Audiology, PC Audiologist-Hearing Aid Fitter CurrentSince Apr 4, 2016 Accepting new patients

Locations

1400 37th Ave SW
Minot, ND 58701
Phone (701) 852-6565

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": "1469145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1469145600000",
    "number": "1508219775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 37TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587017339",
            "telephone_number": "701-852-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 37TH AVE SW",
            "city": "MINOT",
            "state": "ND",
            "postal_code": "587017339",
            "telephone_number": "701-852-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "PHILIP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-22",
        "last_updated": "2016-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "ND",
            "license": "1516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minot, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2016; 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.