REBECCA WISE (NPI# 1891100954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891100954 |
| Entity Type | Individual |
| Full Name | REBECCA WISE |
| Credential | DO |
| Practice Address |
49650 Cherry Hill Rd Ste 210 Canton MI 48187-4859 |
| Mailing Address |
24 Frank Lloyd Wright Dr Ste J2000 Ann Arbor MI 48105-9484 |
| Practice Telephone | 7343987899 |
| Practice Fax Number | 7343987895 |
| Mailing Telephone | 7347476766 |
| Mailing Fax Number | 7342223100 |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2020-10-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 5101025665 | MI | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 0102205010 | VA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 1891100954 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 901 E Mount Hope Ave, Lansing, MI 489103207 | 5172673400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053828418 | Rebecca Wise | Social Worker | 15 Spinning Wheel Rd, Hinsdale, IL 60521-2914 | 2018-01-08 |
| 1700210887 | Rebecca Leigh Wise | Speech-Language Pathologist | 4477 9th Ave Ne, Rio Rancho, NM 87124-5634 | 2013-08-26 |
| 1881993228 | Rebecca Alicia Wise | Pharmacist | 500 Northside Dr E, Statesboro, GA 30458-4841 | 2011-03-24 |
| 1033417597 | Rebecca A Wise | Occupational Therapist | 6506 Loisdale Rd, Suite 302, Springfield, VA 22150-1824 | 2011-03-08 |
| 1598938227 | Rebecca Mcswain Wise | Registered Nurse | 13 S High St, Morgantown, WV 26501-7546 | 2008-04-02 |
| 1770606162 | Rebecca Miller Wise | Pharmacist | 1858 W Grandview Blvd, Bayfront Campus - Lecom Mtm Services, Erie, PA 16509-1025 | 2007-04-09 |
| Street Address |
49650 CHERRY HILL RD STE 210 |
| City | CANTON |
| State | MI |
| Zip Code | 48187-4859 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780784850 | Kerry Anne Swanton | Nurse Practitioner | 49650 Cherry Hill Rd Ste 210, Canton, MI 48187-4859 | 2006-09-25 |
| 1467728618 | Christine Faith Victoria | Pediatrics | 49650 Cherry Hill Rd Ste 210, Canton, MI 48187-4859 | 2012-03-31 |
| 1972829125 | Avram Derrow | Pediatrics | 49650 Cherry Hill Rd Ste 210, Canton, MI 48187-4859 | 2010-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114547874 | Savannah Dugan | Occupational Therapist | 5969 N Canton Center Rd, Canton, MI 48187 | 2020-04-23 |
| 1225674823 | Cura Professional Group | Home Health | 1638 East Lakeview Lane, Canton, MI 48187 | 2019-11-19 |
| 1740825207 | Vlp Can LLC | Dentist | 39883 Ford Rd., Canton, MI 48187 | 2019-11-08 |
| 1487112942 | Michigan Dialysis Services, LLC | Clinic/Center | 275 N Canton Center Rd, Canton, MI 48187 | 2019-03-04 |
| 1447734496 | Integrated Health Pharmacy LLC | Pharmacy | 49650 Cherry Hill Rd., Canton, MI 48187 | 2018-09-16 |
| 1285117499 | Susan Rhoton | Licensed Vocational Nurse | 6223 N Canton, Suite 201, Canton, MI 48187 | 2018-09-13 |
| 1285110767 | Personalized Nursing Light House Inc | Substance Abuse Rehabilitation Facility | 7752 N Canton Center Rd Ste 120, Canton, MI 48187 | 2018-07-17 |
| 1083111793 | Heydie Alejandra Orr | Social Worker | 5840 N Canton Center Rd Ste 221, Canton, MI 48187 | 2018-04-09 |
| 1285139204 | Chawla Enterprises Inc | Durable Medical Equipment & Medical Supplies | 5840 N Canton Center Rd Ste 222, Canton, MI 48187 | 2018-03-30 |
| 1689192221 | Arcturus Pllc | Physical Therapist | 5820 Lilley Rd. Suite 6, Canton, MI 48187 | 2017-09-04 |
| Find all providers in zip 48187 | ||||
| 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 |
|---|---|---|---|---|
| 1801264098 | Dhanalakshmi Senniappan | Pediatrics | Henry Ford Canton Medical Center, 6100 N Haggerty Rd, Canton, MI 48187-2169 | 2015-09-04 |
| 1215294350 | Christina Lynn Hernandez | Pediatrics | 1558 Riverstone Pkwy Ste 100, Canton, GA 30114 | 2012-04-13 |
| 1194037150 | Pediatric Center of Canton, LLC | Pediatrics | 1445 Harrison Ave. Nw, Suite 300 & 306, Canton, OH 44708 | 2010-07-07 |
| 1194046318 | Megan Ann Olson | Pediatrics | 1051 North Canton Rd, Canton, MI 48187-5097 | 2010-06-22 |
| 1992026140 | Jordan H Weitzner | Pediatrics | 2020 Cumming Hwy Ste 102, Canton, GA 30115-8071 | 2010-06-22 |
| 1639407679 | Augusto Rafael Martinez | Pediatrics | 1208 Davenport Ave, Canton, MA 02021-1012 | 2009-12-03 |
| 1295989002 | E. A. Malacaman M. D. LLC | Pediatrics | 3120 Parkway St Nw Ste C, Canton, OH 44708 | 2008-11-06 |
| 1922261106 | Jonathan A. Cheek, M.d. | Pediatrics | 134 Riverstone Ter, Suite 103, Canton, GA 30114-1706 | 2008-07-08 |
| 1598923294 | Hayley Griffin Teich | Pediatrics | 49650 Cherry Hill Rd Suite 210, Canton, MI 48187-1920 | 2008-05-29 |
| 1699832519 | G A Carmichael Family Health Center Inc | Pediatrics | 644 Finney Road, Canton, MS 39046 | 2007-01-02 |
| Find all providers in CANTON | ||||
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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.