Individual provider Active NPI

Brian Patrick Wiseman

  • Occupational Therapy Assistant
  • Christiansburg, VA
National Provider Identifier
1669059226
Registry record updated Mar 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Therapy AssistantTaxonomy code 224Z00000X
License
0131002428 Issued in VA
Practice address
100 Arbor Dr Ste 103
Christiansburg, VA 24073-6585
Phone
(540) 443-3428
NPI assigned
Mar 28, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 224Z00000X 0131002428 VA Primary

Addresses

Primary practice location

100 Arbor Dr Ste 103
Christiansburg, VA 24073-6585

Mailing address

14900 Cumberland Gap Rd
New Castle, VA 24127-7749

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0131002428VAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Warm Hearth at Home, Inc. CurrentSince Apr 6, 2021 Accepting new patients

Locations

100 Arbor Dr
Ste 103
Christiansburg, VA 24073
Phone (540) 443-3428

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1616889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616889600000",
    "number": "1669059226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14900 CUMBERLAND GAP RD",
            "city": "NEW CASTLE",
            "state": "VA",
            "postal_code": "241277749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ARBOR DR STE 103",
            "city": "CHRISTIANSBURG",
            "state": "VA",
            "postal_code": "240736585",
            "telephone_number": "540-443-3428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "BRIAN",
        "middle_name": "PATRICK",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-28",
        "last_updated": "2021-03-28",
        "certification_date": "2021-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "VA",
            "license": "0131002428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Christiansburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2021; 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.