Douglas William Wisor, MD

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

0101052685 Issued in VA

Practice address

13700 St Francis Blvd Ste 501
Midlothian, VA 23114

Phone

(703) 914-8000

Fax

(703) 642-1876

NPI assigned

Mar 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Interventional Pain Center PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Fayetteville, NC
  • NPI 1558428789
  NPD
• Interventional Pain Center, PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Lumberton, NC
  • NPI 1790220408
  NPD
• Physicians Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Ft Myers, FL
  • NPI 1770588584
  NPD
• Physical Medicine Associates LTD

  • Clinical Laboratory Director (Non-physician)
  • Columbia, MD
  • NPI 1750840666
  NPD (past)

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562803200000",
    "number": "1902874449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11350 MCCORMICK ROAD",
            "address_2": "EXECUTIVE PLAZA 1, SUITE 501",
            "city": "HUNT VALLEY",
            "state": "MD",
            "postal_code": "21031",
            "telephone_number": "410-329-1071",
            "fax_number": "410-329-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13700 ST FRANCIS BLVD STE 501",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "23114",
            "telephone_number": "703-914-8000",
            "fax_number": "703-642-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISOR",
        "first_name": "DOUGLAS",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2019-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "010152685",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "VA",
            "license": "0101052685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6802966",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "douglaswisor@nspc.medalliesdirect.net",
            "affiliation": "N",
            "address_1": "13700 St Francis Blvd Ste 501",
            "city": "Midlothian",
            "state": "VA",
            "country_code": "US",
            "postal_code": "23114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amaka O Winslow, SLP
• Cory Wirt, PT, MS PT, TPI-CGFI
• Emily Wirthman, PA-C
• Aukse Wirz, O.D.
• Wisdom Care
• Victoria E Witt, DO
• Timothy James Wittenauer
• Megan Leigh Wittenberg, OT/L
• Rossano N Wlodawsky, DDS
• Laura Wojdyla

• Interventional Pain Medicine Physician in Midlothian, VA
• Providers in Midlothian, VA by specialty
• Interventional Pain Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.