Kathryn B Wiseman, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

159650 Issued in MA

Practice address

77 Hospital Ave
Suite 302
North Adams, MA 01247-2550

Phone

(413) 663-8365

Fax

(413) 662-2363

NPI assigned

Dec 21, 2005

Last updated

Jun 22, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kwiseman14013@direct.chppoc.masshiway.net

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.

• Northern Berkshire Pediatrics, LLP

  • Pediatrics Physician
  • North Adams, MA
  • NPI 1750596201
  NPD (past)
• Williamstown Medical Associates PC

  • Internal Medicine Physician
  • Williamstown, MA
  • NPI 1154319200
  NPD (past)

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308700800000",
    "number": "1649256660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 HOSPITAL AVE",
            "address_2": "SUITE 302",
            "city": "NORTH ADAMS",
            "state": "MA",
            "postal_code": "012472550",
            "telephone_number": "413-663-8365",
            "fax_number": "413-662-2363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 HOSPITAL AVE",
            "address_2": "SUITE 302",
            "city": "NORTH ADAMS",
            "state": "MA",
            "postal_code": "012472550",
            "telephone_number": "413-663-8365",
            "fax_number": "413-662-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "KATHRYN",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-21",
        "last_updated": "2011-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "159650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1006997",
            "state": "VT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3195210",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Williamstown Behavioral Health Associates (Sullivan Associates Behavioral Health)
• Williamstown Behavioral Health Associates
• Willowood of North Adams, Inc. (North Adams Commons Nursing and Rehabilitation Center)
• Michael K. Wilson, M.D.
• Georgia Wingblade
• Rhonda Ann Wood, SLPCCC
• Woolnough Dental PLLC (Greylock Dental)
• Benjamin Woolnough, DMD
• Carly Wright
• Shahrzad Yamini, MD

• Pediatrics Physician in North Adams, MA
• Providers in North Adams, MA by specialty
• Pediatrics Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2011; 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.