Pamela Lawson Wise

Primary specialty

Developmental TherapistTaxonomy code 222Q00000X

Practice address

1460 Holiday Blvd
Merritt Island, FL 32952-5537

Phone

(049) 414-5927

NPI assigned

Sep 3, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Pamela Moore Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1409702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650585600000",
    "number": "1679973010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 HOLIDAY BLVD",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329525537",
            "telephone_number": "704-941-4592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 HOLIDAY BLVD",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329525537",
            "telephone_number": "049-414-5927"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1460 Holiday Blvd",
            "address_purpose": "LOCATION",
            "city": "Merritt Island",
            "state": "FL",
            "postal_code": "329525537",
            "country_code": "US",
            "telephone_number": "704-941-4592",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "PAMELA",
        "middle_name": "LAWSON",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-09-03",
        "last_updated": "2022-04-22",
        "certification_date": "2022-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "MOORE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Travia D Williams, RN
• Ana Maria Williamsen, L.M.T.
• Stephanie M Williamson, LPN
• Bruce Ranne Wills, M.P.T.
• James Henry Wilson III, MD
• Daniel Woodard, M.D.
• Veronica Jean Wright
• Wuesthoff Brevard Cardiology Group
• Wuesthoff Multi-Specialty Physicians, LLC
• Wuesthoff Partners in Womens Health LLC

• Developmental Therapist in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Developmental Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2022; 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.