DR. MARK EDWIN WISNER (NPI# 1598771586) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598771586 |
| Entity Type | Individual |
| Full Name | DR. MARK EDWIN WISNER |
| Credential | PH.D., PA-C |
| Practice Address |
4101 S 4th St Vamc Rm. A541 Leavenworth KS 66048-5014 |
| Practice Telephone | 9137585416 |
| Practice Fax Number | 9137584219 |
| Mailing Telephone | 9137585416 |
| Mailing Fax Number | 9137584219 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2010-09-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA 15-000385 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA-15-000385 | KS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KS | 100340730A | 05 | |
| KS | BLUE CROSS/BLUE SHIELD | 426715 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083829162 | Mark Andrew Wisner | Family Medicine | 214 South 4th Street, Kremmling, CO 80459-0399 | 2007-05-11 |
| Street Address |
4101 S 4TH ST VAMC RM. A541 |
| City | LEAVENWORTH |
| State | KS |
| Zip Code | 66048-5014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437151701 | Scott A Smith | Physical Therapist | 4101 S 4th St, Leavenworth, KS 66048-5014 | 2005-06-01 |
| 1568084895 | Robert Bugh | Registered Nurse | 4101 S 4th St, Leavenworth, KS 66048-5014 | 2020-05-08 |
| 1073134045 | Shay Thomas Ioerger | Radiologic Technologist | 4101 S 4th St, Leavenworth, KS 66048-5014 | 2020-04-30 |
| 1548808389 | Deborah Ann Curtis | Registered Nurse | 4101 S 4th St, Leavenworth, KS 66048-5014 | 2019-12-11 |
| 1821644451 | Jennifer Anne Shah | Psychologist | 4101 S 4th St, Leavenworth, KS 66048-5014 | 2019-08-09 |
| 1558914580 | Michelle Hogg | Social Worker | 4101 S 4th St, Leavenworth, KS 66048-5014 | 2019-07-18 |
| 1235782533 | Elizabeth Weinmann | Counselor | 4101 S 4th St, Leavenworth, KS 66048-5014 | 2019-07-17 |
| 1144872631 | Lindsey Rachelle Schmidling | Social Worker | 4101 S 4th St, Leavenworth, KS 66048-5014 | 2019-07-15 |
| 1063071967 | Leo-anthony Nnamdi Ojini | Nurse Practitioner | 4101 S 4th St, Leavenworth, KS 66048-5014 | 2019-06-13 |
| 1386201283 | Ashley Suzanne Towell | Licensed Practical Nurse | 4101 S 4th St, Leavenworth, KS 66048-5014 | 2019-05-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023653854 | Dawn Rishelle Hudson | Registered Nurse | 711 Marshall St., Leavenworth, KS 66048 | 2019-11-15 |
| 1427606706 | Nathan A Laskowski | Dentist | 3507 S 4th St. Trafficway, Leavenworth, KS 66048 | 2019-08-29 |
| 1386100220 | Aligned Health Chiropractic, LLC | Chiropractor | 402 Delware Street, Leavenworth, KS 66048 | 2019-02-15 |
| 1255805917 | Jordan Rachelle Kloepper | Chiropractor | 402 Delaware Street, Leavenworth, KS 66048 | 2019-01-16 |
| 1851862270 | Sarah Jane Wallace | Nurse Practitioner | Saint John Urgent Care, 3550 S 4th St, Ste B, Leavenworth, KS 66048 | 2018-12-11 |
| 1194222034 | Christie Ann Nelson | Psychologist | 4101 4th Street Trafficway, Leavenworth, KS 66048 | 2018-04-08 |
| 1558865782 | Sunflower Counseling Center LLC | Clinic/Center | 205 S 5th St Ste 15, Leavenworth, KS 66048 | 2018-03-21 |
| 1578062824 | Insoon G Hoagland | Marriage & Family Therapist | 205 S 5th St Ste 20, Leavenworth, KS 66048 | 2018-02-01 |
| 1467804542 | Raechel Marie Mackey | Nurse Practitioner | 4101 S 4th St Bldg 160, Leavenworth, KS 66048 | 2016-07-12 |
| 1073969598 | Kristen Simpson | Chiropractor | 211-b Delaware Street, Leavenworth, KS 66048 | 2016-05-13 |
| Find all providers in zip 66048 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164465290 | Douglas A Kaufman | Physician Assistant | 4101 S 4th St, Leavenworth, KS 66048-5014 | 2006-06-14 |
| 1285694216 | Wanda Johnston | Physician Assistant | 4101 S 4th St, Leavenworth, KS 66048-5014 | 2006-03-24 |
| 1184683583 | Lorree Huffman | Physician Assistant | 4101 S 4th St, Leavenworth, KS 66048-5014 | 2006-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487277703 | Riann Paige Tyree | Physician Assistant | 724 W Lincoln Ave, Greensburg, KS 67054-2522 | 2020-05-20 |
| 1891270674 | Kathryn Denise Boomer | Physician Assistant | 929 St. Francis N, Wichita, KS 67214 | 2018-09-27 |
| 1912408717 | Alyssa Ann Farrell | Physician Assistant | 235 W Vine St., Dighton, KS 67839 | 2018-02-27 |
| 1740790500 | Tory Christopher Fisher | Physician Assistant | 22450 S Harrison St Ste 100, Spring Hill, KS 66083-8882 | 2017-10-06 |
| 1619407871 | Lisa Raylene Steers | Physician Assistant | Po Box 10, Hugoton, KS 67951-0010 | 2017-06-19 |
| 1922547371 | Anna Ruelberg | Physician Assistant | 4921 W 18th Street, Lawrence, KS 66047-2090 | 2017-02-17 |
| 1255888319 | Morgan J Martin | Physician Assistant | 2610 N Woodlawn, Wichita, KS 67220 | 2016-09-07 |
| 1598135808 | Tracy Hoelting | Physician Assistant | 1150 N 75th Pl Ste 200, Kansas City, KS 66112-2466 | 2015-09-29 |
| 1437409901 | Crystal A Nelson | Physician Assistant | 9350 E 35th St N, Ste 101, Wichita, KS 67226 | 2012-09-12 |
| 1306195193 | Jessica M Hughbanks | Physician Assistant | 101 Industrial Rd, Hillsboro, KS 67063-9602 | 2012-09-07 |
| Find all providers with the same taxonomy | ||||
| City | LEAVENWORTH |
| Zip Code | 66048 |
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| 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.