Ellen Jane Wise, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11001850 Issued in FL

Practice address

401 S Netherwood Cres
Altamonte Springs, FL 32714-3149

Phone

(407) 797-5975

NPI assigned

Mar 22, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659398400000",
    "number": "1649730029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S NETHERWOOD CRES",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327143149",
            "telephone_number": "407-797-5975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S NETHERWOOD CRES",
            "city": "ALTAMONTE SPRINGS",
            "state": "FL",
            "postal_code": "327143149",
            "telephone_number": "407-797-5975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "ELLEN",
        "middle_name": "JANE",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2022-08-02",
        "certification_date": "2022-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11001850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gloria Ann Wilson
• Liyana Wilson
• David. Winston, PT
• Kaley Winters
• Wise Cracks LLC
• Emily R Wolfe, MD
• Alicia A Alonso Wolff, APRN
• Catherine Schwarzkopf Wolfson, LMHC, LMFT, RN
• Kayla Wong, LMT
• Kristy Wood, DC

• Family Nurse Practitioner in Altamonte Springs, FL
• Providers in Altamonte Springs, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.