Individual provider Active NPI

Daren Daniel Wise, APRN

  • Acute Care Nurse Practitioner
  • Amarillo, TX
National Provider Identifier
1649862285
Registry record updated Jun 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1027305 Issued in TX
Practice address
7908 Progress Dr
Amarillo, TX 79119-7310
Phone
(806) 335-0551
NPI assigned
Feb 4, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1027305 TX Primary

Addresses

Primary practice location

7908 Progress Dr
Amarillo, TX 79119-7310

Mailing address

PO Box 840026
Dallas, TX 75284-0026
Phone (806) 212-6965

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210629002494 TX Practitioner - Nurse Practitioner 6103227053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bsa Physicians Group IncGroup PAC ID 3971748146, 121 clinicians

Practice addresses (Care Compare)

1600 Wallace Blvd
Amarillo, TX 79106-1799
Phone (806) 212-2129

Hospital & facility affiliations

  • Bsa Hospital Hospital, Amarillo, TX, CCN 450231
  • Southwest Medical Center Hospital, Liberal, KS, CCN 170068
  • Swisher Memorial Hospital Hospital, Tulia, TX, CCN 451349

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Bsa Physicians Group Inc CurrentSince Jun 25, 2021 Accepting new patients
Bsa Physicians Group Inc CurrentSince Jun 25, 2021 Accepting new patients

Locations

1751 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2129

1600 Wallace Blvd
Amarillo, TX 79106
Phone (806) 212-2000

Interoperability endpoints

  • Direct secure messaging: dwise22158@ahs.direct-ci.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1612396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624406400000",
    "number": "1649862285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840026",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840026",
            "telephone_number": "806-212-6965",
            "fax_number": "806-212-6278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7908 PROGRESS DR",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791197310",
            "telephone_number": "806-335-0551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "DAREN",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-04",
        "last_updated": "2021-06-23",
        "certification_date": "2021-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1027305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.