Kimberly J Wise, PH.D., M.AUD., CCC-A

Primary specialty

Audiologist-Hearing Aid FitterTaxonomy code 237600000X

License

115898 Issued in IA

Practice address

3601 N Division St
Davenport, IA 52806-5450

Phone

(563) 326-5441

Fax

(888) 336-4118

NPI assigned

Oct 17, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Qualified Audiologist

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prescott Ear Nose and Throat PLLCGroup PAC ID 3779562749, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Prescott Ear Nose & Throat PLLC

  • Specialist
  • Prescott, AZ
  • NPI 1811198393
  Medicare reassignment Care Compare group NPD
• Parker Audiology, P.C.

  • Audiologist-Hearing Aid Fitter
  • Davenport, IA
  • NPI 1740510601
  NPD

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

{
    "created_epoch": "1665964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1891411203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 N DIVISION ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528065450",
            "telephone_number": "563-326-5441",
            "fax_number": "888-336-4118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 N DIVISION ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528065450",
            "telephone_number": "563-326-5441",
            "fax_number": "888-336-4118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "KIMBERLY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D., M.AUD., CCC-A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-17",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "IA",
            "license": "115898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Nicole Wilson, NP
• Rickey L. Wilson, M.D.
• Laura L Winchip, DC
• Craig A Winder
• Allyson Winter, DO
• Alyssa N Wislander, ARNP
• Mary Wisnieski, LMSW
• William J Witcik, M.D,
• Stephanie Witherow, FNP
• Shelley A Witt-Gentile, MA/CCC-A

• Audiologist-Hearing Aid Fitter in Davenport, IA
• Providers in Davenport, IA by specialty
• Audiologist-Hearing Aid Fitter in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.