Active NPI
William Wise
- Optician
- Otisville, MI
National Provider Identifier
1588201420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- Practice address
- 410 North St
Otisville, MI 48463-9705 - Phone
- (810) 374-6410
- NPI assigned
- Dec 10, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | Primary |
Addresses
Primary practice location
410 North St
Otisville, MI 48463-9705
Mailing address
410 North St
Otisville, MI 48463-9705
Phone (810) 374-6410
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Otisville |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1575936000000",
"number": "1588201420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 NORTH ST",
"city": "OTISVILLE",
"state": "MI",
"postal_code": "484639705",
"telephone_number": "810-374-6410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 NORTH ST",
"city": "OTISVILLE",
"state": "MI",
"postal_code": "484639705",
"telephone_number": "810-374-6410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISE",
"first_name": "WILLIAM",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-12-10",
"last_updated": "2019-12-10",
"certification_date": "2019-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Otisville",
"affiliation": "N",
"address_1": "410 North St",
"city": "Otisville",
"state": "MI",
"country_code": "US",
"postal_code": "484639705",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Otisville, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.