Individual provider Active NPI

Michael B Wiseman, FNP

  • Nurse Practitioner
  • Oak Ridge, TN
National Provider Identifier
1689637340
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
16227 Issued in TN
Practice address
800 Oak Ridge Turnpike
Suite a-402
Oak Ridge, TN 37830
Phone
(865) 637-8812
Fax
(865) 824-4886
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201214 NC
Nurse Practitioner 363L00000X 16227 TN Primary

Addresses

Primary practice location

800 Oak Ridge Turnpike
Suite a-402
Oak Ridge, TN 37830

Mailing address

1450 Dowell Springs Blvd
Suite 300
Knoxville, TN 37909
Phone (865) 637-8812

Other identifiers 1

IdentifierTypeStateIssuer
1529982MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, TN2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20040610001759 NC Practitioner - Nurse Practitioner 6406839380 Reassigns benefits to 1 organization
I20121105000622 TN Practitioner - Nurse Practitioner 6406839380

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of North Carolina at Chapel Hill School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Quickcare Family Practice, PLLCGroup PAC ID 0840682340, 107 clinicians

Practice addresses (Care Compare)

4612 Main St
Shallotte, NC 28470-4452
Phone (910) 444-2970

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16227TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Quickcare Family Practice, PLLC CurrentSince Feb 13, 2025 Accepting new patients
Cherokee Indian Hospital Authority Past Accepting new patients
Cherokee Indian Hospital Authority Past Accepting new patients
Total Renal Care of North Carolina LLC Past Accepting new patients
Uhs Ventures PastSince Jul 24, 2022 Accepting new patients

Locations

2265 NC Highway 24 27 E
Biscoe, NC 27209
Phone (919) 810-0054

4612 Main St
Shallotte, NC 28470
Phone (910) 444-2970

Organizations & group practices 5

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": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1689637340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 DOWELL SPRINGS BLVD",
            "address_2": "SUITE 300",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "37909",
            "telephone_number": "865-637-8812",
            "fax_number": "865-637-8865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 OAK RIDGE TURNPIKE",
            "address_2": "SUITE A-402",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "37830",
            "telephone_number": "865-637-8812",
            "fax_number": "865-824-4886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "MICHAEL",
        "middle_name": "B",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "201214",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "16227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1529982",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

Verify at the official NPI Registry.