ZACHARY CORDELL WISE (DO) – Emergency Medicine Physician, NPI 1447710777
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,686 EMERGENCY MEDICINE in OH
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Provider Addresses for ZACHARY CORDELL WISE (DO)
403, Butterfly Circle, Happy Acres, Athens, Limestone County, Alabama, 35611, United States
ATHENS, AL 356112012
Phone: (256) 497-2244
Type: Mailing
Mercy Saint Vincent Medical Center, 2213, Cherry Street, Birckhead Place, Toledo, Lucas County, Ohio, 43608, United States
TOLEDO, OH 436082603
Phone: (256) 497-2244
Type: Location
2213 Cherry St
Toledo, OH 436082603
Phone: (256) 497-2244
Type: Location
2817 ROCK MERRITT AVE
FORT BRAGG, NC 283100001
Phone: (910) 907-8922
Type: Mailing
2661 W 3400 S
SYRACUSE, UT 840758066
Phone: (256) 497-2244
Type: Mailing
7321 BALMER ST BLDG 570
HILL AFB, UT 840565012
Phone: (801) 586-2273
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-11-11
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20221109003222 | I | Emergency Medicine | UT | TBD |
| I20231205001178 | I | Emergency Medicine | NV | TBD |
| I20251111003663 | I | Emergency Medicine | NC | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 35611)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | TX | |
| Emergency Medicine | DC | |
| - | NC | |
| Emergency Medicine | DE | |
| Emergency Medicine | TX | |
| Emergency Medicine | TX | |
| Emergency Medicine | MI | |
| - | WA | |
| Nurse Practitioner | NC | |
| Physician Assistant | NC |
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