Individual provider Active NPI

Jonathan R Wispe, MD

  • Neonatal-Perinatal Medicine Physician
  • Columbus, OH
National Provider Identifier
1851466338
Registry record updated Dec 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
35052332 Issued in OH
Practice address
555 S 18TH St
Columbus, OH 43205-2654
Phone
(614) 722-4559
Fax
(614) 722-4541
NPI assigned
Nov 21, 2006
Last updated
Dec 2, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 35052332 OH Primary

Addresses

Primary practice location

555 S 18TH St
Columbus, OH 43205-2654

Mailing address

555 S 18TH St
Columbus, OH 43205-2654
Phone (614) 722-4559

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241007002952 AZ Practitioner - Pediatric Medicine 4082606199 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35052332OHMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner-University Medical Group CurrentSince Sep 30, 2024 Accepting new patients
Banner-University Medical Group CurrentSince Sep 30, 2024 Accepting new patients
Banner-University Medical Group Pediatrics Current Accepting new patients
Pediatric Academic Association, Inc. Pediatrics Past Accepting new patients
Nationwide Children's Hospital Past Accepting new patients

Locations

2800 E Ajo Way
Tucson, AZ 85713
Phone (520) 294-4471

1625 N Campbell Ave
Tucson, AZ 85719

6200 N La Cholla Blvd
Tucson, AZ 85741
Phone (520) 229-2657

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228176000000",
    "number": "1851466338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 S 18TH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052654",
            "telephone_number": "614-722-4559",
            "fax_number": "614-722-4541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S 18TH ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052654",
            "telephone_number": "614-722-4559",
            "fax_number": "614-722-4541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISPE",
        "first_name": "JONATHAN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2008-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "OH",
            "license": "35052332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.