Jillian Wise, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Practice address

880 6TH St S
Suite 420
St Petersburg, FL 33701-4827

Phone

(727) 767-8477

NPI assigned

Sep 13, 2016

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• Pediatric Physician Services, Inc.

  • Pediatrics Physician
  • St Petersburg, FL
  • NPI 1770532798
  NPD (past)

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473724800000",
    "number": "1740738301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 3RD AVE N",
            "address_2": "#203",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337013322",
            "telephone_number": "574-612-5293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 6TH ST S",
            "address_2": "SUITE 420",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337014827",
            "telephone_number": "727-767-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "JILLIAN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-13",
        "last_updated": "2016-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen Wisby, ARNP
• Gustavo J Wiscovitch, DMD
• Wise Care Medical Supplies Inc
• Wise Mind Psychology Center
• Elizabeth Wise, ARNP
• Brittany D Wisehart
• Jared Wishik, M.D.
• Danielle Marie Wishnow, DNP, CPNP-PC
• Irma H M Witbreuk, OTR
• Erin L Witek, PHD

• Clinical Neuropsychologist in St Petersburg, FL
• Providers in St Petersburg, FL by specialty
• Clinical Neuropsychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2016; 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.