Roger P. Wise, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

00914 Issued in MO

Practice address

306 S Independence St
Harrisonville, MO 64701-2352

Phone

(816) 380-4010

Fax

(816) 887-5703

NPI assigned

Oct 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fastcomprehensivecare.rogerwise@155276.advancedmd-direct.com

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.

• Sondermind Provider Network LLC

  • Clinical Social Worker
  • Denver, CO
  • NPI 1760854442

  MO

  Medicare reassignment Care Compare group NPD
• Communitty Mental Health Consultants, Inc.

  • Family Nurse Practitioner
  • Nevada, MO
  • NPI 1740330406
  Medicare reassignment
• Community Mental Health Consultants, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Harrisonville, MO
  • NPI 1073729323

  Clinical

  NPD (past)

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1942390455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 S INDEPENDENCE ST",
            "city": "HARRISONVILLE",
            "state": "MO",
            "postal_code": "647012352",
            "telephone_number": "816-380-4010",
            "fax_number": "816-887-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "306 S INDEPENDENCE ST",
            "city": "HARRISONVILLE",
            "state": "MO",
            "postal_code": "647012352",
            "telephone_number": "816-380-4010",
            "fax_number": "816-887-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "ROGER",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2008-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "00914",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "07108031",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "493233209",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth A Williamson, PHARMD
• Willow Brooke Homes
• Amanda Sue Wilson, FNP-BC
• Marlene Wilson
• Crystal Dawn Wise, FNP
• Mary Woods, LPC
• Ashlee Nichole Worthey, PHARM.D.
• Yoma Psychiatric Solutions LLC
• Leslie Zarker, LCPC, LPC

• Clinical Psychologist in Harrisonville, MO
• Providers in Harrisonville, MO by specialty
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; 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.
• 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.