Trina Wisecup, D.O

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS-008301-L Issued in PA

Practice address

3156 Kensington Ave
Philadelphia, PA 19134-2400

Phone

(215) 831-1100

Fax

(215) 807-8951

NPI assigned

Dec 19, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1281571200000",
    "number": "1700949815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3156 KENSINGTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191342400",
            "telephone_number": "215-831-1100",
            "fax_number": "215-807-8951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3156 KENSINGTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191342400",
            "telephone_number": "215-831-1100",
            "fax_number": "215-807-8951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISECUP",
        "first_name": "TRINA",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2010-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS-008301-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1752064",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueleen Wise, CRNP
• Kariyma Wise, CRNP
• Lauren Elizabeth Wise, CRNP
• Sabrina Wise
• Stephen Wise, R.PH
• Kenneth Wiseman, DO
• Wisemind Wellness, LLC
• Wiseminds Healthcare Network
• Wiser Counseling, LLC
• Christopher J Wisgo, M.D.

• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2010; 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.