Healthwise Medical Practice LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

HEALTHWISE MEDICAL PRACTICE LLC

Practice address

1415 Colonial Blvd
Fort Myers, FL 33907-1043

Phone

(239) 202-4517

NPI assigned

Sep 27, 2018

Organization subpart

No

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

Authorized official

Name

Jessie Martin, MDNPI 1073547972

Title

Physician

Phone

(646) 267-6718

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jessie Martin, MD

  • General Practice Physician
  • Fort Myers, FL
  • NPI 1073547972
  NPD (past) Authorized official

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

{
    "created_epoch": "1538006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538006400000",
    "number": "1821573684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8140 LIRIOPE LOOP",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339727546",
            "telephone_number": "646-267-6718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 COLONIAL BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071043",
            "telephone_number": "239-202-4517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHWISE MEDICAL PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-27",
        "last_updated": "2018-09-27",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "646-267-6718",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• General Practice Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; 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.