Keith Patrick Wisberger, PRS

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

150 Cross Street
Akron, OH 44311-1026

Phone

(330) 996-9141

NPI assigned

Jul 29, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• The Light Center Recovery LLC

  • Community/Behavioral Health Agency
  • Cuyahoga Falls, OH
  • NPI 1124652649

  Case Manager/Care Coordinator

  NPD (past)

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

{
    "created_epoch": "1722211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1922837129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 CROSS STREET",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443111026",
            "telephone_number": "330-996-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 CROSS STREET",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443111026",
            "telephone_number": "330-996-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISBERGER",
        "first_name": "KEITH",
        "middle_name": "PATRICK",
        "credential": "PRS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-29",
        "last_updated": "2024-11-06",
        "certification_date": "2024-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OH",
            "license": "APS.005211",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wintercare Health Services
• Caitlyn Wires
• Kevin Wires, CRNA
• Kathryn Wirth
• Nichole Wirtzberger, ED. S.
• Barbie Marie Wise
• Benjimin Wise Jr.
• Corey Wise, RPH
• Gregory Wise, PHARMD
• Keri Wise

• Case Manager/Care Coordinator in Akron, OH
• Providers in Akron, OH by specialty
• Case Manager/Care Coordinator in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.