Individual provider Active NPI

William E Wise Jr., D.O

  • Internal Medicine Physician
  • Waxahachie, TX
National Provider Identifier
1508945593
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
50666 Issued in CO
Practice address
2460 N Ih 35 E Ste 100
Waxahachie, TX 75165-5267
Phone
(469) 800-9500
Fax
(303) 302-0808
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 50666 CO Primary
Internal Medicine Physician 207R00000X 4353 AZ

Addresses

Primary practice location

2460 N Ih 35 E Ste 100
Waxahachie, TX 75165-5267

Mailing address

2460 N Ih 35 E Ste 100
Waxahachie, TX 75165-5267
Phone (469) 800-9500

Other identifiers 1

IdentifierTypeStateIssuer
151086MedicaidAZ

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address wwise225901@direct.sw.org

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
I20150506002365 TX Practitioner - Internal Medicine 5496755589 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Arizona College of Osteopathic Medicine Mid Western University, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

2460 N Ih 35E
100 Baylor Scott and White
Waxahachie, TX 75165-5267
Phone (469) 800-9500

4001 Worth St
Dallas, TX 75246-1608

821 N Coleman St
Suite 100
Prosper, TX 75078-2339
Phone (469) 800-5200

Hospital & facility affiliations

  • Texas Home Health Group of Desoto, LLC Home health agency, Desoto, TX, CCN 679103
  • Baylor Scott & White Medical Center- Waxahachie Hospital, Waxahachie, TX, CCN 450372
  • Baylor Scott & White Institute for Rehabilitation Inpatient rehabilitation facility, Dallas, TX, CCN 453036

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50666COMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Apr 1, 2019 Accepting new patients
Healthtexas Provider Network CurrentSince Apr 1, 2019 Accepting new patients
Healthtexas Provider Network Internal Medicine Current Accepting new patients
Catholic Health Initiatives Colorado Past Accepting new patients
Center for Physical Medicine & Rehabilitation P C Past Accepting new patients
Med 97 LLC Past Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

700 Walter Reed Blvd
Ste 203
Garland, TX 75042
Phone (972) 426-9900

1441 S Midlothian Pkwy
Ste 100A
Midlothian, TX 76065
Phone (469) 800-9440

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

2460 N Interstate Highway 35 E
Ste 100
Waxahachie, TX 75165
Phone (469) 800-9500

Organizations & group practices 7

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.

Hospital & facility affiliations 3

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1508945593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 N IH 35 E STE 100",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751655267",
            "telephone_number": "469-800-9500",
            "fax_number": "469-800-9505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 N IH 35 E STE 100",
            "city": "WAXAHACHIE",
            "state": "TX",
            "postal_code": "751655267",
            "telephone_number": "469-800-9500",
            "fax_number": "303-302-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "WILLIAM",
        "middle_name": "E",
        "name_suffix": "Jr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "50666",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "4353",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "151086",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wwise225901@direct.sw.org",
            "affiliation": "N",
            "address_1": "2460 N Ih 35 E Ste 100",
            "city": "Waxahachie",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751655267",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Waxahachie, TX

Sources for this page

Verify at the official NPI Registry.