MR. PAUL PENCE WISMAN JR. (NPI# 1235115650) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235115650 |
| Entity Type | Individual |
| Full Name | MR. PAUL PENCE WISMAN JR. |
| Credential | M.D. |
| Practice Address |
1011 E Jefferson St Charlottesville VA 22902-5354 |
| Mailing Address |
104 Kerry Ln Charlottesville VA 22901-2925 |
| Practice Telephone | 4342969161 |
| Practice Fax Number | 4342961036 |
| Mailing Telephone | 4349733806 |
| Enumeration Date | 2005-12-17 |
| Last Update Date | 2012-09-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 0101049022 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | SOUTHERN HEALTH | 12211500001 | 01 |
| VA | VETRI | 42728 | 01 |
| VA | 006725856 | 05 | |
| VA | MAMSI/ALLIANCE | 267258 | 01 |
| VA | ANTHEM | 333848 | 01 |
| VA | CIGNA | 010724 | 01 |
| Street Address |
1011 E JEFFERSON ST |
| City | CHARLOTTESVILLE |
| State | VA |
| Zip Code | 22902-5354 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447232905 | Lori W. Balaban | Pediatrics | 1011 E Jefferson St, Charlottesville, VA 22902-5354 | 2005-11-18 |
| 1962942474 | Jennifer Fontenot | Pediatrics | 1011 E Jefferson St, Charlottesville, VA 22902-5354 | 2017-03-02 |
| 1851743835 | Morgan Rush Newsome | Pediatrics | 1011 E Jefferson St, Charlottesville, VA 22902-5354 | 2016-07-01 |
| 1710307467 | Amy Malek | Pediatrics | 1011 E Jefferson St, Charlottesville, VA 22902 | 2014-04-21 |
| 1033557541 | Sarah Catherine Wenzinger | Pediatrics | 1011 E Jefferson St, Charlottesville, VA 22902-5354 | 2013-06-06 |
| 1013202928 | Marion Elizabeth Szwedo | Pediatrics | 1011 E Jefferson St, Charlottesville, VA 22902-5354 | 2011-06-20 |
| 1205126703 | Amanda Parsons Jones | Pediatrics | 1011 E Jefferson St, Charlottesville, VA 22902-5354 | 2011-04-18 |
| 1720247562 | Sarah Ellen Knight | Pediatrics | 1011 E Jefferson St, Charlottesville, VA 22902-5354 | 2008-06-06 |
| 1184891244 | Alaina Marie Brown | Pediatrics | 1011 E Jefferson St, Charlottesville, VA 22902-5354 | 2008-05-08 |
| 1659441608 | Pediatric Associates of Charlottesville | Audiologist | 1011 E Jefferson St, Charlottesville, VA 22902-5354 | 2006-11-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699263608 | Jeraline Rachele Evans | Health Educator | 151 Mcintire Park Dr. (piedmont Family Ymca), Charlottesville, VA 22902 | 2018-04-25 |
| 1457853905 | Elizabeth Blaker Tyson Walter | Speech-Language Pathologist | 401 Mcintire Rd. Room 323, Charlottesville, VA 22902 | 2018-03-01 |
| 1376056317 | Erin E Horn | Psychologist | 302 Park St Ste 204, Charlottesville, VA 22902 | 2017-11-13 |
| 1023429982 | Barrie Gleason Carveth | Nurse Practitioner | 435 Merchant Walk Sq, Charlottesville, VA 22902 | 2014-05-14 |
| 1285054825 | Alfred N. Yarbrough | Dentist | 1101 East Jefferson Street, Suite 7, Charlottesville, VA 22902 | 2014-04-22 |
| 1801227400 | Fox & Brantley Internal Medicine, A Division of Anchor Healthcare, Plc | Internal Medicine | 908 E Jeffeson St, Suite G1, Charlottesville, VA 22902 | 2013-12-06 |
| 1245557982 | Wendy Price Summer | Counselor | 509 Park Street, Charlottesville, VA 22902 | 2010-04-20 |
| 1659520914 | Christie Marie Savage | Acupuncturist | 108 5th St Se, Suite 207, Charlottesville, VA 22902 | 2008-09-11 |
| 1376733063 | Alison C. Derbes | Radiology | 107 S 1st St, Apartment 401, Charlottesville, VA 22902 | 2007-07-28 |
| 1275732901 | Cali Belknap Gaston | Acupuncturist | 420 Third Street, Ne, Charlottesville, VA 22902 | 2007-07-12 |
| Find all providers in zip 22902 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619363058 | Elizabeth Dexter-rice | Pediatrics | 1204 W Main Street Floor 6, Charlottesville, VA 22908-0816 | 2015-04-13 |
| 1578958526 | Kaitlin R. Blackard | Pediatrics | 1204 Main St Fl 6, Charlottesville, VA 22908-0816 | 2015-04-06 |
| 1215270558 | Erin Suzanne Kalan | Pediatrics | 111 Apple Tree Rd, Charlottesville, VA 22903-2906 | 2013-04-05 |
| 1760688105 | Valentina J. Intagliata | Pediatrics | 1105 W Main St Rm 1421, Charlottesville, VA 22903-2821 | 2007-06-22 |
| 1053526210 | Jason M Glover | Pediatrics | Lee Street 4th Floor, Charlottesville, VA 22908-0001 | 2007-05-11 |
| 1447329081 | Heather R. Quillian | Pediatrics | 2955 Ivy Rd Ste 303, Charlottesville, VA 22903-9353 | 2006-11-07 |
| 1841370566 | Kathryn A Cook | Pediatrics | 895 B Rio East Court, Charlottesville, VA 22901 | 2006-10-17 |
| 1538252291 | Eric Norman Rydland | Pediatrics | 1921 Commonwealth Dr, Charlottesville, VA 22901-2382 | 2006-10-02 |
| 1487681581 | James Linn Plews-ogan | Pediatrics | 1412 Sachem Pl, Suite 203, Charlottesville, VA 22901-2499 | 2006-06-26 |
| 1104869767 | Amy L. Wrentmore | Pediatrics | Lee St Fl 4, Charlottesville, VA 22908-0001 | 2006-06-13 |
| Find all providers in CHARLOTTESVILLE | ||||
| City | CHARLOTTESVILLE |
| Zip Code | 22902 |
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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.