Lori M Wisely M D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01042996 Issued in IN

Legal business name

LORI M WISELY M D

Practice address

1060 S Main St
Tipton, IN 46072-8327

Phone

(765) 675-2069

Fax

(765) 675-7327

NPI assigned

May 16, 2008

Last updated

May 16, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lori M Wisely, MDNPI 1508856832

Title

Physician

Phone

(765) 675-2069

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lori M Wisely, MD

  • Family Medicine Physician
  • Tipton, IN
  • NPI 1508856832
  Authorized official Same address or phone

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

{
    "created_epoch": "1210896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210896000000",
    "number": "1831356062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1060 S MAIN ST",
            "address_2": "PO BOX 286",
            "city": "TIPTON",
            "state": "IN",
            "postal_code": "460728327",
            "telephone_number": "765-675-2069",
            "fax_number": "765-675-7327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 S MAIN ST",
            "city": "TIPTON",
            "state": "IN",
            "postal_code": "460728327",
            "telephone_number": "765-675-2069",
            "fax_number": "765-675-7327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LORI M WISELY M D",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-16",
        "last_updated": "2008-05-16",
        "status": "A",
        "authorized_official_last_name": "WISELY",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "765-675-2069",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01042996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200106590A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles Lai, MD
• Destry W Lambert, MD
• Walter Samuel Langkau, D.D.S.
• Kristi S Leap, MSW, LCSW
• Janette R Link
• Mary Katherine Mariotti, FNP-BC
• Christopher McDaniel, DC
• McQuinn Family Dentistry PC
• Kassey McQuinn, D.D.S.
• Kiley McQuinn

• Family Medicine Physician in Tipton, IN
• Providers in Tipton, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2008; 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.