Active NPI
Steven Dwayne Wise, M.D.
- Endocrinology, Diabetes & Metabolism Physician
- Dothan, AL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- 00015918
- Practice address
- 1118 Ross Clark Cir
Suite 100
Dothan, AL 36301-3001 - Phone
- (334) 794-1148
- Fax
- (334) 793-1954
- NPI assigned
- May 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 00015918 | AL | Primary |
Addresses
Primary practice location
1118 Ross Clark Cir
Suite 100
Dothan, AL 36301-3001
Mailing address
1118 Ross Clark Cir
Suite 100
Dothan, AL 36301-3001
Phone (334) 794-1148
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000032731 | Medicaid | AL | |
| 051032731 | Other | AL | BCBS |
| 630991466 | Other | AL | TRICARE |
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00015918 | AL | MD | Endocrinology, Diabetes & Metabolism Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| TMH Physician Associates PLLC | Current | Accepting new patients | |
| TMH Physician Associates PLLC | Endocrinology, Diabetes & Metabolism | Current | Accepting new patients |
| Dothan Medical Associates, P.C. | Current | Accepting new patients | |
| Hospital Authority of the City of Bainbridge and Decatur County | Past | Accepting new patients |
Locations
1118 Ross Clark Cir
Ste 100
Dothan, AL 36301
Phone (334) 794-1148
1118 Ross Clark Cir
Dothan, AL 36301
Phone (334) 699-2004
7575 San Felipe St
Ste 155
Houston, TX 77063
Phone (713) 266-9955
6550 Fannin St
Ste 447
Houston, TX 77030
Phone (713) 441-0633
16605 Southwest Fwy
Ste 400
Sugar Land, TX 77479
Phone (281) 275-0800
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.37
- swise259037@directhoustonmethodist.org
Organizations & group practices 4
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.
-
- Ophthalmology Physician
- Houston, TX
- NPI 1275779225
Endocrinology, Diabetes & Metabolism
-
- Internal Medicine Physician
- Dothan, AL
- NPI 1972693778
-
- Orthopaedic Surgery Physician
- Spring, TX
- NPI 1043061351
-
- Multi-Specialty Clinic/Center
- Bainbridge, GA
- NPI 1053388256
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1327363200000",
"number": "1659327468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1118 ROSS CLARK CIR",
"address_2": "SUITE 100",
"city": "DOTHAN",
"state": "AL",
"postal_code": "363013001",
"telephone_number": "334-794-1148",
"fax_number": "334-793-1954"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1118 ROSS CLARK CIR",
"address_2": "SUITE 100",
"city": "DOTHAN",
"state": "AL",
"postal_code": "363013001",
"telephone_number": "334-794-1148",
"fax_number": "334-793-1954"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISE",
"first_name": "STEVEN",
"middle_name": "DWAYNE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-25",
"last_updated": "2012-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "AL",
"license": "00015918",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000032731",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "051032731",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "630991466",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dothan, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2012; 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.