Individual provider Active NPI

Russell Logan Wise, DC

  • Chiropractor
  • Savannah, GA
National Provider Identifier
1750181640
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR011369 Issued in GA
Practice address
315 Commercial Dr Ste C5
Savannah, GA 31406-3633
Phone
(912) 433-8788
NPI assigned
Mar 18, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR011369 GA Primary

Addresses

Primary practice location

315 Commercial Dr Ste C5
Savannah, GA 31406-3633

Mailing address

144 Jabez Jones Rd
Guyton, GA 31312-6023

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251105004745 GA Practitioner - Chiropractic 7911496427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1219 Merchant Way
Suite 101
Statesboro, GA 30458-0885
Phone (912) 433-8788

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR011369GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Wise Choice Chiropractic LLC Chiropractor CurrentSince Sep 1, 2025 Accepting new patients

Locations

315 Commercial Dr
Ste C5
Savannah, GA 31406
Phone (912) 354-1522

1219 Merchant Way
Ste 101
Statesboro, GA 30458
Phone (912) 433-8788

Organizations & group practices 1

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": "1742256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1750181640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 JABEZ JONES RD",
            "city": "GUYTON",
            "state": "GA",
            "postal_code": "313126023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 COMMERCIAL DR STE C5",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063633",
            "telephone_number": "912-433-8788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "RUSSELL",
        "middle_name": "LOGAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-03-18",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR011369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; 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.