LORI ANNE WISE (CPNP) – Pediatric Nurse Practitioner, NPI 1912096249
Pediatric Nurse Practitioner
Main info
Contacts
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for LORI ANNE WISE (CPNP)
102 HIGHLAND AVE SE STE 455
ROANOKE, VA 240132202
Phone: (540) 224-4445
Type: Mailing
213 S JEFFERSON ST STE 1006
ROANOKE, VA 240111713
Phone: (540) 224-5715
Type: Mailing
4348 ELECTRIC RD
ROANOKE, VA 240180720
Phone: (540) 769-0976
Fax: (540) 857-5386
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $358.
Total Amount is formed as General ($358) + Research ($0) + Ownership ($0) = $358.
Last reported payment date: 2024-12-10 • Largest payer in this snapshot: Abbott Laboratories ($119).
Total Amount
$358
General + Research + Ownership
Payments
4
Total payment records
General Amount
$358
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-10
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Abbott Laboratories | $119 |
| BETA BIONICS, INC. | $119 |
| SANOFI-AVENTIS U.S. LLC | $103 |
| Dexcom, Inc. | $17 |
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: 2019-12-02
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20120420000404 | I | Nurse Practitioner | SC | TBD |
| I20191202001541 | I | Nurse Practitioner | VA | 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 24013)
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