Individual provider Active NPI

Kimberly S Wiseman, CNM

  • Advanced Practice Midwife
  • Muscatine, IA
National Provider Identifier
1972570083
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
B094547 Issued in IA
Practice address
1518 Mulberry Ave
Muscatine, IA 52761-3433
Phone
(563) 262-4113
Fax
(563) 264-9167
NPI assigned
Mar 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X B094547 IA Primary

Addresses

Primary practice location

1518 Mulberry Ave
Muscatine, IA 52761-3433

Mailing address

1518 Mulberry Ave
Muscatine, IA 52761-3433
Phone (563) 262-4113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20050520000033 IA Practitioner - Certified Nurse Midwife (CNM) 3072554997 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa Physicians Clinic Medical FoundationGroup PAC ID 8729992318, 1,254 clinicians

Practice addresses (Care Compare)

4480 Utica Ridge Rd
Suite 108
Bettendorf, IA 52722-1644
Phone (563) 742-5280

Hospital & facility affiliations

  • Trinity Rock Island Hospital, Rock Island, IL, CCN 140280
  • Trinity - Bettendorf Hospital, Bettendorf, IA, CCN 160104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation CurrentSince Jan 1, 2013 Accepting new patients
Iowa Physicians Clinic Medical Foundation CurrentSince Jan 1, 2013 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 108
Bettendorf, IA 52722
Phone (563) 324-7272

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

1518 Mulberry Ave
Muscatine, IA 52761
Phone (563) 262-4110

8101 Birchwood Ct
Unit R
Urbandale, IA 50131
Phone (515) 471-9363

Interoperability endpoints

  • Direct secure messaging: kwiseman162156@direct.unitypoint.org

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1972570083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1518 MULBERRY AVE",
            "city": "MUSCATINE",
            "state": "IA",
            "postal_code": "527613433",
            "telephone_number": "563-262-4113",
            "fax_number": "563-264-9167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1518 MULBERRY AVE",
            "city": "MUSCATINE",
            "state": "IA",
            "postal_code": "527613433",
            "telephone_number": "563-262-4113",
            "fax_number": "563-264-9167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "KIMBERLY",
        "middle_name": "S",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-07",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "IA",
            "license": "B094547",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muscatine, IA

Sources for this page

Verify at the official NPI Registry.