Individual provider Active NPI

Allisan Wisniewski, NP-C

  • Family Nurse Practitioner
  • Toledo, OH
National Provider Identifier
1639545551
Registry record updated Oct 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.17968 Issued in OH
Practice address
2755 Shoreland Ave
Toledo, OH 43611-1177
Phone
(419) 479-7000
Fax
(419) 473-9758
NPI assigned
Aug 14, 2015
Last updated
Oct 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.17968 OH Primary

Addresses

Primary practice location

2755 Shoreland Ave
Toledo, OH 43611-1177

Mailing address

2200 Jefferson Ave
5TH Floor
Toledo, OH 43604-7101

Other identifiers 1

IdentifierTypeStateIssuer
0146233MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151023000485 OH Practitioner - Nurse Practitioner 8224347794 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Promedica Central PhysiciansGroup PAC ID 2365348190, 785 clinicians
Mercy Health Physicians-North LLCGroup PAC ID 2668522400, 131 clinicians

Practice addresses (Care Compare)

1620 Brigham Dr
Perrysburg, OH 43551-7124
Phone (567) 585-2040

2755 Shoreland Ave
Toledo, OH 43611-1177
Phone (419) 479-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.17968OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians - North, LLC CurrentSince Sep 30, 2015 Accepting new patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians North Specialty Care LLC CurrentSince Sep 1, 2021 Accepting new patients
Mercy Health Physicians-North LLC CurrentSince Sep 30, 2015 Accepting new patients
Mercy Health System Northern Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

2222 Cherry St
Ste 2300
Toledo, OH 43608
Phone (419) 251-8013

2200 Jefferson Ave
Fl 5
Toledo, OH 43604
Phone (419) 251-9826

2755 Shoreland Ave
Toledo, OH 43611
Phone (419) 479-7000

3900 Sunforest Ct
Ste 240
Toledo, OH 43623
Phone (419) 472-3126

723 Phillips Ave
Ste 201
Toledo, OH 43612
Phone (419) 476-2124

Interoperability endpoints

  • Direct secure messaging: awisniewski78588@direct.bsmhealth.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1439510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728691200000",
    "number": "1639545551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 JEFFERSON AVE",
            "address_2": "5TH FLOOR",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436047101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2755 SHORELAND AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436111177",
            "telephone_number": "419-479-7000",
            "fax_number": "419-473-9758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "ALLISAN",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-14",
        "last_updated": "2024-10-12",
        "certification_date": "2024-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.17968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0146233",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toledo, OH

Sources for this page

Verify at the official NPI Registry.