John Anthony Wise, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704323970 Issued in MI

Practice address

21540 W 11 Mile Rd
Ste 200
Southfield, MI 48076-3843

Phone

(248) 352-2000

Fax

(248) 352-8800

NPI assigned

Sep 7, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: john.wise.1@32913.direct.athenahealth.com

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.

• Iah of Michigan, PLLC

  • Family Medicine Physician
  • Troy, MI
  • NPI 1578969705
  Medicare reassignment NPD
• Vpa PC

  • Family Medicine Physician
  • Portage, MI
  • NPI 1669091864
  Medicare reassignment NPD
• Vpa PC

  • Family Medicine Physician
  • Troy, MI
  • NPI 1336153295
  NPD
• Harmonycares Complete Health Services, PLLC

  • Family Medicine Physician
  • Jackson, MS
  • NPI 1093543902
  NPD
• Vpa PC

  • Family Medicine Physician
  • Brentwood, TN
  • NPI 1578363362
  NPD

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475712000000",
    "number": "1659828663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13033 DIVERSEY ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261152",
            "telephone_number": "248-352-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21540 W 11 MILE RD",
            "address_2": "STE 200",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480763843",
            "telephone_number": "248-352-2000",
            "fax_number": "248-352-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "name_prefix": "Mr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704323970",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95002731",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Winston
• Irene Janet Wintermyer, PA
• Tova E Winters, NP
• Ruthanne K Wirth, CRNA
• Wisdom Home Health Care Inc
• Susan Lynn Wise, LMSW
• Stephanie Wisniewski, TLLP
• Sydney Wisniewski
• Kelsey Wisotsky
• Omeria Witcher, LLMSW

• Family Nurse Practitioner in Southfield, MI
• Providers in Southfield, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2016; 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.