Individual provider Active NPI

Kontasha Shamika Wise, ARNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1679850044
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
CNP02817 Issued in NM
Practice address
8226 Menaul Blvd NE # 144
Albuquerque, NM 87110-4614
Phone
(505) 544-2366
NPI assigned
Nov 12, 2011
Last updated
Sep 5, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 17616 SC
Adult Health Nurse Practitioner 363LA2200X CNP02817 NM
Family Nurse Practitioner 363LF0000X CNP02817 NM
Psychiatric/Mental Health Nurse Practitioner 363LP0808X CNP02817 NM Primary
Primary Care Nurse Practitioner 363LP2300X CNP02817 NM

Addresses

Primary practice location

8226 Menaul Blvd NE # 144
Albuquerque, NM 87110-4614

Mailing address

8226 Menaul Blvd NE # 144
Albuquerque, NM 87110-4614
Phone (505) 544-2366

Other identifiers 1

IdentifierTypeStateIssuer
6929753MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NM, FL, TX4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20120409000685 SC Practitioner - Nurse Practitioner 5395906960 Reassigns benefits to 5 organizations
I20171206001432 NM Practitioner - Nurse Practitioner 5395906960 Reassigns benefits to 5 organizations
I20251029000173 FL Practitioner - Nurse Practitioner 5395906960 Reassigns benefits to 2 organizations
I20251212003853 TX Practitioner - Nurse Practitioner 5395906960 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Interactionmatters, LLCGroup PAC ID 5193085421, 6 clinicians
Psychiatry of Texas PLLCGroup PAC ID 0345573598, 418 clinicians
Brave Health Medical Group, PAGroup PAC ID 9537586052, 93 clinicians

Practice addresses (Care Compare)

102 Gold Ave SW
Suite 548
Albuquerque, NM 87102-3335
Phone (505) 660-8047

302 University Pkwy
Aiken, SC 29801-6302
Phone 8328694818235

4700 N Habana Ave
Suite 601
Tampa, FL 33614-7160
Phone 8328694818235

675 Town Square Blvd
Garland, TX 75040-2992
Phone (305) 579-9538

7877 Willow Chase Blvd
Houston, TX 77070-5934
Phone 8328694818235

9310 Coors Blvd NW
Albuquerque, NM 87114-4006
Phone 8328694818235

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP02817NMMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatry of Texas PLLC Multi-Specialty CurrentSince Oct 1, 2025 Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Sep 1, 2021 Accepting new patients
Brave Health Medical Group PA Multi-Specialty CurrentSince Oct 5, 2025 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Multi-Specialty Current Accepting new patients
South Carolina Dept of Mental Health Accounting Office Multi-Specialty CurrentSince Nov 1, 2021 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Multi-Specialty Current Accepting new patients
Psychplus Medical Associates, PLLC Multi-Specialty CurrentSince Oct 1, 2025 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Multi-Specialty CurrentSince Sep 1, 2021 Accepting new patients
Interactionmatters, LLC Multi-Specialty CurrentSince Jan 30, 2026 Accepting new patients

Locations

250 2nd St E
Ste 4C
Bradenton, FL 34208
Phone (941) 744-5860

6700 Winkler Rd
Ste 4
Fort Myers, FL 33919
Phone 8328694818 ext. 235

5995 SE Community Dr
Stuart, FL 34997
Phone (727) 424-3427

4700 N Habana Ave
Ste 601
Tampa, FL 33614
Phone (201) 706-1143

102 Gold Ave SW
#548
Albuquerque, NM 87102
Phone (505) 660-8047

5000 Cutler Ave NE
Ste A
Albuquerque, NM 87110
Phone (505) 227-7434

9310 Coors Blvd NW
Albuquerque, NM 87114
Phone (505) 431-1900

1135 Gregg Hwy NW
Aiken, SC 29801
Phone (803) 641-7700

1510 Whiskey Rd
Ste 2
Aiken, SC 29803

302 University Pkwy
Aiken, SC 29801
Phone (803) 279-3940

524 Doctors Ct
Chester, SC 29706
Phone (803) 325-7744

221 Adley Way
Greenville, SC 29607
Phone (661) 378-0517

12180 N Mopac Expy
Ste B
Austin, TX 78758
Phone (512) 836-4999

12221 Merit Dr
Ste 450
Dallas, TX 75251
Phone (214) 217-1900

2110 W Trenton Rd
Ste A
Edinburg, TX 78539
Phone (956) 289-8200

3100 Alliance Town Ctr
Fort Worth, TX 76177
Phone (409) 938-5166

675 Town Square Blvd
Ste 200
Garland, TX 75040
Phone (305) 579-9538

7877 Willow Chase Blvd
Houston, TX 77070
Phone 8328694818109

23838 Highway 59 N
Kingwood, TX 77339
Phone (832) 869-4814

Interoperability endpoints

  • Direct secure messaging: kwise@bmc-nm.direct.office.nextgen.com

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1321056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1679850044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8226 MENAUL BLVD NE # 144",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104614",
            "telephone_number": "505-544-2366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8226 MENAUL BLVD NE # 144",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871104614",
            "telephone_number": "505-544-2366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "KONTASHA",
        "middle_name": "SHAMIKA",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-12",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "17616",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NM",
            "license": "CNP02817",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "CNP02817",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NM",
            "license": "CNP02817",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NM",
            "license": "CNP02817",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6929753",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.