Individual provider Active NPI

Breon Wise

  • Student in an Organized Health Care Education/Training Program
  • New Orleans, LA
National Provider Identifier
1508705310
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
Lsu Emergency Medicine Umc D&T
2000 Canal Street, 2ND FL Suite 2720
New Orleans, LA 70112
Phone
(504) 451-0515
NPI assigned
Mar 26, 2026
Last updated
Apr 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary

Addresses

Primary practice location

Lsu Emergency Medicine Umc D&T
2000 Canal Street, 2ND FL Suite 2720
New Orleans, LA 70112

Mailing address

Lsu Emergency Medicine Umc D&T
2000 Canal Street, 2ND FL Suite 2720
New Orleans, LA 70112
Phone (504) 451-0515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20260624003622 LA Order and Referring Only - Emergency MedicinePractitioner - Emergency Medicine 3072086792

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1774483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1508705310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LSU EMERGENCY MEDICINE UMC D&T",
            "address_2": "2000 CANAL STREET, 2ND FL SUITE 2720",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70112",
            "telephone_number": "504-451-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LSU EMERGENCY MEDICINE UMC D&T",
            "address_2": "2000 CANAL STREET, 2ND FL SUITE 2720",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70112",
            "telephone_number": "504-451-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "BREON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-26",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.