JOHN DAVID WISE (NPI# 1093739724) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093739724 |
| Entity Type | Individual |
| Full Name | JOHN DAVID WISE |
| Credential | PA |
| Practice Address |
2793 Lineville Rd Green Bay WI 54313-7152 |
| Mailing Address |
Po Box 19070 Prevea Health Green Bay WI 54307-9070 |
| Practice Telephone | 9204964700 |
| Practice Fax Number | 9204964705 |
| Mailing Telephone | 9204964700 |
| Mailing Fax Number | 9204964705 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2009-05-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 941 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 42989000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760882732 | John Wise | Physical Therapist | 112 E 4th Ave, Columbus, OH 43201-3506 | 2014-08-27 |
| 1548499635 | John David Wise | Dentist | B 2817 Reilly Rd, Fort Bragg, NC 28310-7302 | 2009-07-09 |
| 1942428859 | John B Wise | Dentist | 6960 Parkwood Blvd, #100, Frisco, TX 75034 | 2007-04-23 |
| 1447322326 | John H Wise | Optometrist | 509 N. Avenue G, Crowley, LA 70526 | 2006-11-15 |
| 1881779817 | John William Wise | Physical Therapist | 2612 Eagle St, Anchorage, AK 99503-2818 | 2006-10-26 |
| 1780765404 | John Michael Wise | Dentist | 985 Russell Avenue, Gaithersburg, MD 20879 | 2006-10-18 |
| 1154355535 | John Flint Wise | Social Worker | 1170 County Road 1389, Chickasha, OK 73018-4100 | 2006-07-10 |
| 1184675522 | John Edney Wise | Legal Medicine | 11 13th Ave Ne, Hickory, NC 28601-3700 | 2006-05-12 |
| 1528616729 | John Richard Wise | Specialist/Technologist | 1501 Lakeside Dr, Lynchburg, VA 24501-3113 | 2019-08-30 |
| 1396246310 | John Wise | Chore Provider | 6384 Covenant Crest Ct, Las Vegas, NV 89131-1300 | 2018-02-25 |
| Street Address |
2793 LINEVILLE RD |
| City | GREEN BAY |
| State | WI |
| Zip Code | 54313-7152 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932172053 | Susan Frangiskakis | Specialist | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2006-02-09 |
| 1063026276 | Matthew John Sprister | Nurse Practitioner | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2020-09-04 |
| 1780215251 | Christine Hyde | Nurse Practitioner | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2020-02-03 |
| 1275049140 | Miranda Mary Cseter | Physician Assistant | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2017-12-14 |
| 1205205424 | Jennifer N. Charles | Registered Nurse | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2015-09-17 |
| 1316222771 | Tiffany Lynn Laughlin | Nurse Practitioner | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2011-10-18 |
| 1720217722 | St Vincent Hospital-hospital Sisters-third Order of St Francis | Durable Medical Equipment & Medical Supplies | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2009-07-11 |
| 1154563229 | Joshua D Rankin | Pediatrics | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2009-04-03 |
| 1336300276 | Bradley Allen Locke | Pediatrics | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2008-06-23 |
| 1003080102 | Mark Andrew Kachan | Podiatrist | 2793 Lineville Rd, Green Bay, WI 54313-7152 | 2008-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548823420 | Martha Lynn Drew | Licensed Practical Nurse | 3101 Molly Brown Lane, Green Day, WI 54313 | 2019-04-17 |
| 1831691872 | Melanie Hammerbeck | Dentist | 1756 Cardinal Ln, Green Bay, WI 54313 | 2018-03-06 |
| 1649727108 | Amanda Marie Mckeefry | Dental Hygienist | 2304 Lineville Rd, Suite 101, Green Bay, WI 54313 | 2016-09-01 |
| 1326594813 | Kaylee Schartner | Dental Hygienist | 2304 Lineville Road, Suite 100, Suamico, WI 54313 | 2016-08-25 |
| 1134500226 | Salvanz Enterprises Inc | Pharmacy | 2673 Lineville Road, Green Bay, WI 54313 | 2015-06-15 |
| 1467849307 | Maureen Riordan | Specialist/Technologist | 2957 S Telemark Cir., Green Bay, WI 54313 | 2015-04-17 |
| 1043556780 | Kellen James Binder | Chiropractor | 2638 Tulip Lane, Suite B, Green Bay, WI 54313 | 2012-12-28 |
| 1407092737 | Sara Ann Anderson | Registered Nurse | 2691 Shade Tree Ln, Green Bay, WI 54313 | 2008-12-16 |
| 1467601344 | Melissa Lea Socha | Speech-Language Pathologist | 2153 School Lane, Suamiro Elementary, Green Bay, WI 54313 | 2008-09-16 |
| 1003070707 | Anne Marie Hein | Physical Therapist | 3101 S Packerland Dr, Green Bay, WI 54313 | 2008-07-11 |
| Find all providers in zip 54313 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700253101 | Mathias Dahnert | Physician Assistant | 945 S Irwin Ave, Green Bay, WI 54301-3309 | 2015-09-01 |
| 1770992067 | Sheila M Teddy | Physician Assistant | 2595 Development Dr Ste 150, Green Bay, WI 54311-4288 | 2014-08-12 |
| 1245652718 | Bailey Bauer | Physician Assistant | 2753 Mayline Dr, Green Bay, WI 54311-9646 | 2014-01-17 |
| 1588949333 | Carissa Ann Coorough | Physician Assistant | 720 S Van Buren St Ste 301, Green Bay, WI 54301-3534 | 2011-10-12 |
| 1093942047 | Taresa B Fassbender | Physician Assistant | 3263 Eaton Rd Ste 1, Green Bay, WI 54311-6830 | 2009-06-17 |
| 1265628507 | Colleen M Van Egeren | Physician Assistant | 715 Superior Rd, Suite 120, Green Bay, WI 54311-7594 | 2007-09-20 |
| 1427079516 | Dermatology Clinic S.c. | Physician Assistant | 715 Superior Rd Ste 120, Green Bay, WI 54311-7595 | 2006-07-22 |
| 1316976814 | Kevin F Nelson | Physician Assistant | 3237 Voyager Dr, Green Bay, WI 54311-8349 | 2006-06-30 |
| 1841233186 | Randall R Southards | Physician Assistant | 2845 Greenbrier Rd Ste 320, Green Bay, WI 54311-6519 | 2006-06-14 |
| 1285684662 | Elaine M Smith | Physician Assistant | 301 Bay Park Sq, Green Bay, WI 54304-5104 | 2006-05-10 |
| Find all providers in GREEN BAY | ||||
Please comment or provide details below to improve the information on JOHN DAVID WISE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.