Individual provider Active NPI

Robert James Wishmeyer, PA-C

  • Physician Assistant
  • Meridian, MS
National Provider Identifier
1790755684
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1061148 Issued in MS
Practice address
1801 Fuller Rd
Meridian, MS 39309-5106
Phone
(601) 679-2633
Fax
(601) 679-3232
NPI assigned
Jan 24, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1061148 MS Primary

Addresses

Primary practice location

1801 Fuller Rd
Meridian, MS 39309-5106

Mailing address

1801 Fuller Rd
Meridian, MS 39309-5106
Phone (601) 679-2633

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1061148MSMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1790755684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 FULLER RD",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393095106",
            "telephone_number": "601-679-2633",
            "fax_number": "601-679-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 FULLER RD",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393095106",
            "telephone_number": "601-679-2633",
            "fax_number": "601-679-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISHMEYER",
        "first_name": "ROBERT",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MS",
            "license": "1061148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.