Individual provider Active NPI

Paul Jonathon Wiseman Jr.

  • Family Nurse Practitioner
  • Newark, OH
National Provider Identifier
1811496136
Registry record updated Aug 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.021551 Issued in OH
Practice address
1478 W Main St
Newark, OH 43055-3687
Phone
(740) 366-1648
NPI assigned
Feb 2, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.021551 OH Primary

Addresses

Primary practice location

1478 W Main St
Newark, OH 43055-3687

Mailing address

3499 Belmont Ave
Youngstown, OH 44505-1807
Phone (330) 744-0221

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20200504001272 OH Practitioner - Nurse Practitioner 2860823010 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cleveland Clinic Mercy HospitalGroup PAC ID 0547156796, 92 clinicians
Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

6200 Whipple Ave NW
North Canton, OH 44720-7624
Phone (330) 966-8689

9500 Euclid Ave
Cleveland, OH 44195-0001
Phone (216) 444-5433

Hospital & facility affiliations

  • Mercy Medical Center Hospital, Canton, OH, CCN 360070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Quick Med Urgent Care LLC CurrentSince Jul 1, 2021 Accepting new patients
Incare Health Solutions LLC CurrentSince Mar 20, 2020 Accepting new patients
Incare Health Solutions, LLC Family CurrentSince Mar 20, 2020 Accepting new patients
Cleveland Clinic Mercy Hospital CurrentSince Oct 23, 2023 Accepting new patients
The Cleveland Clinic Foundation CurrentSince Sep 17, 2025 Accepting new patients
Cleveland Clinic Mercy Hospital CurrentSince Oct 23, 2023 Accepting new patients

Locations

4135 Tuscarawas St W
Canton, OH 44708
Phone (330) 546-0913

1330 Mercy Dr NW
Ste 200
Canton, OH 44708
Phone (330) 489-1000

9500 Euclid Ave
Cleveland, OH 44195
Phone (216) 442-1270

211 Edgefield Blvd
Marion, OH 43302

6200 Whipple Ave NW
North Canton, OH 44720
Phone (330) 966-8884

7450 State Route 161 E
Plain City, OH 43064
Phone (614) 504-5002

3499 Belmont Ave
Youngstown, OH 44505
Phone (330) 476-2260

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19801/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.platform.athenahealth.com/1576/brand/1/csg/22/fhir/r4

Organizations & group practices 6

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628467200000",
    "number": "1811496136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3499 BELMONT AVE",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445051807",
            "telephone_number": "330-744-0221",
            "fax_number": "330-744-4716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1478 W MAIN ST",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430553687",
            "telephone_number": "740-366-1648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "PAUL",
        "middle_name": "JONATHON",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-02",
        "last_updated": "2021-08-09",
        "certification_date": "2021-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.021551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.