Kristopher Joel Wise, FNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

4704335001 Issued in MI

Practice address

1522 Janes Ave
Saginaw, MI 48601-1819

Phone

(989) 755-0316

Fax

(989) 755-0956

NPI assigned

Nov 19, 2021

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

Specialty

Nurse Practitioner

Education

Saginaw Valley Medical College - NLG, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Great Lakes Bay Health CentersGroup PAC ID 2466369046, 85 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Covenant Medical Center Hospital, Saginaw, MI, CCN 230070

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kristopher.wise.1@27771.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.

• Great Lakes Bay Health Centers

  • Obstetrics & Gynecology Physician
  • Saginaw, MI
  • NPI 1871684761
  Medicare reassignment Care Compare group NPD
• Great Lakes Bay Health Centers

  • Federally Qualified Health Center (FQHC)
  • Midland, MI
  • NPI 1609609536
  NPD
• Great Lakes Bay Health Centers

  • Federally Qualified Health Center (FQHC)
  • Saginaw, MI
  • NPI 1629171707
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Covenant Medical Center, Inc.

  • General Acute Care Hospital
  • Saginaw, MI
  • NPI 1588656946
  Care Compare affiliation

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

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1679230148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 LAPEER AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486071203",
            "telephone_number": "989-759-6464",
            "fax_number": "989-399-8233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1522 JANES AVE",
            "city": "SAGINAW",
            "state": "MI",
            "postal_code": "486011819",
            "telephone_number": "989-755-0316",
            "fax_number": "989-755-0956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "KRISTOPHER",
        "middle_name": "JOEL",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-19",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "21314035126",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704335001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wisconsin Lutheran Child &Family Service, Inc
• Wisconsin Lutheran Child and Family Service Inc
• Wise Growth Therapy LLC
• Wise Weight Management PC
• Ann M Wise, LMSW
• Ashley Lynn Wisniewski, OTRL
• Kerri Wissmueller, LLBSW
• WKL Inc
• Joni L. Wohlscheid, PT
• Farrah Amanda Wojcik, LMSW

• Primary Care Nurse Practitioner in Saginaw, MI
• Providers in Saginaw, MI by specialty
• Primary Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.