Individual provider Active NPI

Clayton Ellis Wisely

  • Student in an Organized Health Care Education/Training Program
  • Columbus, OH
National Provider Identifier
1669834875
Registry record updated Mar 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
793 W State St
Columbus, OH 43222-1551
Phone
(614) 234-5000
NPI assigned
Mar 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

793 W State St
Columbus, OH 43222-1551

Mailing address

793 W State St
Columbus, OH 43222-1551
Phone (614) 234-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200624002620 NC Practitioner - Ophthalmology 7012204605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

2301 Erwin Rd
Durham, NC 27705-4699
Phone (919) 684-8111

2351 Erwin Rd
Durham, NC 27705-4699
Phone (919) 684-8111

40 Duke Medicine Cir
Durham, NC 27710-4000
Phone (919) 684-8111

5601 Arringdon Park Dr
Morrisville, NC 27560-5676
Phone (919) 684-8111

Hospital & facility affiliations

  • Duke University Hospital Hospital, Durham, NC, CCN 340030

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery137

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients

Locations

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

2100 Erwin Rd
Durham, NC 27705
Phone (919) 648-8111

2351 Erwin Rd
Durham, NC 27705
Phone (919) 282-0053

401 Irving Pkwy
Ste 310
Holly Springs, NC 27540
Phone (919) 385-3800

5601 Arringdon Park Dr
Ste 420
Morrisville, NC 27560
Phone (919) 997-3000

5601 Arringdon Park Dr
Morrisville, NC 27560
Phone (888) 275-3853

3480 Wake Forest Rd
Ste 300
Raleigh, NC 27609
Phone (919) 862-5380

Interoperability endpoints

  • Direct secure messaging: ewisely247288@direct.medicine.duke.edu

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.

Hospital & facility affiliations 6

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": "1458950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459296000000",
    "number": "1669834875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "793 W STATE ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221551",
            "telephone_number": "614-234-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "793 W STATE ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432221551",
            "telephone_number": "614-234-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISELY",
        "first_name": "CLAYTON",
        "middle_name": "ELLIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-26",
        "last_updated": "2016-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.