Julie Harding Wisdom, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA05313 Issued in TX

Practice address

21 Spurs LN
Suite 100
San Antonio, TX 78240-1669

Phone

(210) 614-6070

Fax

(210) 615-6814

NPI assigned

Aug 10, 2007

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

Enrolled in TX

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Blanco Regional Clinic, P.a.

  • Family Medicine Physician
  • Blanco, TX
  • NPI 1164547519
  Medicare reassignment

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571702400000",
    "number": "1760674022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 4TH ST",
            "city": "BLANCO",
            "state": "TX",
            "postal_code": "786064913",
            "telephone_number": "830-833-5581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 SPURS LN",
            "address_2": "SUITE 100",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782401669",
            "telephone_number": "210-614-6070",
            "fax_number": "210-615-6814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISDOM",
        "first_name": "JULIE",
        "middle_name": "HARDING",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-10",
        "last_updated": "2019-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Orion David Wirick, LPC
• Michael D Wirt II, M.D., PH.D.
• Michael A Wirth, MD
• Wisdom Teeth RX PLLC (210 Wisdom Teeth)
• Anthony Michael Wisdom, RPH
• Brenda K Wise-Yount
• David S. Wise, M.D.
• Jason Wise, PSY.D.
• Moreitalya Wise
• William Wise

• Physician Assistant in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.