Organization Active NPI

Jeffrey M Wisser DO LLC

  • Surgery Physician
  • Lima, OH
National Provider Identifier
1659552255
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
JEFFREY M WISSER DO LLC
Practice address
750 W High St
Suite 330
Lima, OH 45801-2969
Phone
(419) 228-1077
Fax
(419) 228-1075
NPI assigned
Nov 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

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

Authorized official

Name
Dr. Jeffrey M Wisser, D.O.
Title
President
Phone
(419) 228-1077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X OH Primary

Addresses

Primary practice location

750 W High St
Suite 330
Lima, OH 45801-2969

Mailing address

750 W High St
Suite 330
Lima, OH 45801-2969
Phone (419) 228-1077

Other identifiers 1

IdentifierTypeStateIssuer
DD6265OtherOHRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

770 W High St
Ste 400
Lima, OH 45801
Phone (419) 224-0084

NPI Registry JSON

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

{
    "created_epoch": "1195948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353888000000",
    "number": "1659552255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 W HIGH ST",
            "address_2": "SUITE 330",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458012969",
            "telephone_number": "419-228-1077",
            "fax_number": "419-228-1075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 W HIGH ST",
            "address_2": "SUITE 330",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458012969",
            "telephone_number": "419-228-1077",
            "fax_number": "419-228-1075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY M WISSER DO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-25",
        "last_updated": "2012-11-26",
        "status": "A",
        "authorized_official_last_name": "WISSER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "419-228-1077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DD6265",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lima, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2012; 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.