Organization Active NPI

Wise Woman OB/GYN, PC

  • Obstetrics & Gynecology Physician
  • Watertown, NY
National Provider Identifier
1649221367
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
WISE WOMAN OB/GYN, PC
Practice address
172 Clinton St
Watertown, NY 13601-3602
Phone
(315) 782-6262
Fax
(315) 782-5181
NPI assigned
May 15, 2006
Last updated
May 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2008

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

Authorized official

Name
Nanci L. Hawkins, MDNPI 1922057710
Title
President
Phone
(315) 782-6262

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X NU
Advanced Practice Midwife 367A00000X NU
Obstetrics & Gynecology Physician 207V00000X NU Primary

Addresses

Primary practice location

172 Clinton St
Watertown, NY 13601-3602

Mailing address

1001 W Fayette St
Ste 400
Syracuse, NY 13204-2859
Phone (315) 472-1488

Other identifiers 1

IdentifierTypeStateIssuer
02751077MedicaidNY

National Provider Directory

National Provider Directory

Locations

172 Clinton St
Watertown, NY 13601
Phone (315) 782-6262

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210032000000",
    "number": "1649221367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 W FAYETTE ST",
            "address_2": "STE 400",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132042859",
            "telephone_number": "315-472-1488",
            "fax_number": "315-476-1792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 CLINTON ST",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136013602",
            "telephone_number": "315-782-6262",
            "fax_number": "315-782-5181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISE WOMAN OB/GYN, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-15",
        "last_updated": "2008-05-06",
        "status": "A",
        "authorized_official_last_name": "HAWKINS",
        "authorized_official_first_name": "NANCI",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "315-782-6262",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02751077",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.