Individual provider Active NPI

Rodney Marvin Wiseman, D.O.

  • Family Medicine Physician
  • Whitehouse, TX
National Provider Identifier
1508832999
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
F4702 Issued in TX
Practice address
#400 Hwy 110 N
Whitehouse, TX 75791-1045
Phone
(903) 839-4396
Fax
(903) 839-8705
NPI assigned
Feb 24, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X F4702 TX Primary

Addresses

Primary practice location

#400 Hwy 110 N
Whitehouse, TX 75791-1045

Mailing address

PO Box 1045
Whitehouse, TX 75791-1045
Phone (903) 839-4396

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040612000386 TX Practitioner - Family PracticePractitioner - General PracticePractitioner - Geriatric MedicinePractitioner - Emergency Medicine 0840273470 Reassigns benefits to 1 organization
Practice locations: Pearland, TX

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine, General Practice, Geriatric Medicine
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2211 Broadway St
Pearland, TX 77581-6403

2211 E Broadway St
Pearland, TX 77581-6403
Phone (281) 412-4949

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Houston Area Family Medical Clinics Family Medicine CurrentSince Jul 5, 2014 Accepting new patients
Limestone Emergency PA Past Accepting new patients
Premier Heart Specialists P a Past Accepting new patients

Locations

2211 Broadway St
Pearland, TX 77581
Phone (281) 412-4949

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EBBBDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/EBBBDD/Endpoint/EBBBDD

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1508832999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1045",
            "city": "WHITEHOUSE",
            "state": "TX",
            "postal_code": "757911045",
            "telephone_number": "903-839-4396",
            "fax_number": "903-839-8705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#400 HWY 110 N",
            "city": "WHITEHOUSE",
            "state": "TX",
            "postal_code": "757911045",
            "telephone_number": "903-839-4396",
            "fax_number": "903-839-8705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "RODNEY",
        "middle_name": "MARVIN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "F4702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitehouse, TX

Sources for this page

Verify at the official NPI Registry.