Individual provider Active NPI

Michelle Tonia Wise, NURSE PRACTITIONER

  • Pediatric Nurse Practitioner
  • Hampton, VA
National Provider Identifier
1942261466
Registry record updated Aug 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024156324 Issued in VA
Practice address
240 S Second St
Hampton, VA 23664-1407
Phone
(757) 713-9465
NPI assigned
Apr 1, 2006
Last updated
Aug 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0024156324 VA Primary
Critical Care Neonatal Nurse Practitioner 363LN0005X 0024156324 VA
Lactation Consultant (Registered Nurse) 163WL0100X 0001156324 VA
Neonatal Nurse Practitioner 363LN0000X 0024156324 VA

Addresses

Primary practice location

240 S Second St
Hampton, VA 23664-1407

Mailing address

240 S Second St
Hampton, VA 23664-1407
Phone (757) 713-9465

Other practice location 1

680 Oyster Point Rd
Newport News, VA 23606-4570
Phone (757) 668-4851

Other practice location 2

314 Peach Tree Cres
Newport News, VA 23602-7485
Phone (757) 874-2489

Other practice location 3

3960 Virginia Beach Blvd
Virginia Beach, VA 23452-2449
Phone (757) 668-4648

Other practice location 4

817 Volvo Pkwy
Chesapeake, VA 23320-2855
Phone (757) 668-4630

Other practice location 5

4000 Coliseum Dr Ste 280A
Hampton, VA 23666-5974
Phone (757) 827-2400

Other identifiers 1

IdentifierTypeStateIssuer
1946661466MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0001156324VAMDLactation Consultant (Registered Nurse)
0024156324VAMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MBS Child Wellness Center CurrentSince Aug 23, 2020 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: michelle.wise.1@6174.direct.athenahealth.com

Organizations & group practices 1

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": "1143849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786060800000",
    "number": "1942261466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 S SECOND ST",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236641407",
            "telephone_number": "757-713-9465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 S SECOND ST",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236641407",
            "telephone_number": "757-713-9465"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "680 Oyster Point Rd",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236064570",
            "country_code": "US",
            "telephone_number": "757-668-4851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "314 Peach Tree Cres",
            "address_purpose": "LOCATION",
            "city": "Newport News",
            "state": "VA",
            "postal_code": "236027485",
            "country_code": "US",
            "telephone_number": "757-874-2489",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3960 Virginia Beach Blvd",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234522449",
            "country_code": "US",
            "telephone_number": "757-668-4648",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "817 Volvo Pkwy",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233202855",
            "country_code": "US",
            "telephone_number": "757-668-4630",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Coliseum Dr Ste 280A",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "VA",
            "postal_code": "236665974",
            "country_code": "US",
            "telephone_number": "757-827-2400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "MICHELLE",
        "middle_name": "TONIA",
        "name_prefix": "Mrs.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-01",
        "last_updated": "2026-08-07",
        "certification_date": "2026-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024156324",
            "primary": true
        },
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "VA",
            "license": "0024156324",
            "primary": false
        },
        {
            "code": "163WL0100X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Lactation Consultant",
            "state": "VA",
            "license": "0001156324",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "VA",
            "license": "0024156324",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1946661466",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; 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.