Jerry a Wishik, M.D., P.a.

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

JERRY A WISHIK, M.D., P.A.

Practice address

620 Vonderburg Dr
Brandon, FL 33511-5971

Phone

(813) 684-1777

Fax

(813) 689-9559

NPI assigned

Jun 17, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jerry A Wishik, M.D.NPI 1396772190

Title

Medical Director

Phone

(813) 684-1777

Specialties & licenses 1

Addresses

Other names 1

• PHYSICIAN CARE WALK-IN CLINIC Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jerry A Wishik, M.D.

  • Internal Medicine Physician
  • Brandon, FL
  • NPI 1396772190
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699710467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 VONDERBURG DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115971",
            "telephone_number": "813-684-1777",
            "fax_number": "813-689-9559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 VONDERBURG DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115971",
            "telephone_number": "813-684-1777",
            "fax_number": "813-689-9559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY A WISHIK, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WISHIK",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "813-684-1777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "FL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHYSICIAN CARE WALK-IN CLINIC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Jennett, MSW
• Jennifer a. Mannion
• Ron Matthew Jennings, PT
• Samantha Jennings
• Sabrina Jerrels, OTR/L
• Jessica K. Mahoney, Psy.D., P.a.
• Nevaeh Liara Jessup, RBT
• Dayna Jetmore
• Lawanya Jeyaselvan, MD
• Linzi Jiang, MD

• Clinic/Center in Brandon, FL
• Providers in Brandon, FL by specialty
• Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.