Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1891100954 Individual Practitioner Female Practitioner

Dr. Rebecca Wise , DO

Pediatrics • Canton, MI

Professional Overview & Biography Verified Profile Summary

Dr. Rebecca Wise, DO is a registered healthcare professional specializing in Pediatrics in Canton, MI. Practice services are available at 49650 CHERRY HILL RD STE 210 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

49650 Cherry Hill Rd Ste 210

Canton, MI 481874859

Telephone 7343987899
Fax 7343987895
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Canton, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 20.2 Yrs
State Avg: 25.7 Yrs
Regional Practice Density
40 Specialists

Practicing in Canton, MI (2263 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-10-08
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License MI 5101025665

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.

Pediatrics

NUCC Taxonomy Code: 208000000X

State License VA 0102205010

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
1891100954 (VA)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

21 Associated Practitioners
Wendy Storey , CNP

Nurse Practitioner - Pediatrics

NPI 1013015155

Certified Nurse Practitioner

Molly Mcintyre , CNP

Nurse Practitioner - Pediatrics

NPI 1013015163

Certified Nurse Practitioner

Patricia Reckling , CNP

Nurse Practitioner - Pediatrics

NPI 1043310618

Certified Nurse Practitioner

NPI 1053389593

Doctor of Medicine (M.D.)

NPI 1104048115

Doctor of Medicine (M.D.)

NPI 1144286550

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

14 Historical Events
📍
Updated Practice Location October 08, 2020

Registered at 49650 CHERRY HILL RD STE 210, CANTON, MI 481874859 (Tel: 7343987899)

📍
Updated Business Mailing Address October 08, 2020

Registered at 24 FRANK LLOYD WRIGHT DR STE J2000, ANN ARBOR, MI 481059484 (Tel: 7347476766)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 18, 2020

Pediatrics (License #0102205010 in VA)

NPI Profile Active January 16, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location January 16, 2018

Registered at 8640 SUDLEY RD STE 340, MANASSAS, VA 201104420 (Tel: 7033303939)

📍
Updated Business Mailing Address January 16, 2018

Registered at 8640 SUDLEY RD STE 340, MANASSAS, VA 201104420

👤
Provider Name / Credentials Updated January 16, 2018

Recorded as REBECCA WISE, DO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 16, 2018

Pediatrics (License #5101021411 in MI)

NPI Profile Active June 27, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location June 27, 2014

Registered at 901 E MOUNT HOPE AVE, LANSING, MI 489103207 (Tel: 5172673400)

📍
Updated Business Mailing Address June 27, 2014

Registered at 901 E MOUNT HOPE AVE, LANSING, MI 489103207

👤
Provider Name / Credentials Updated June 27, 2014

Recorded as REBECCA JUSTIN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 27, 2014

Pediatrics (License #5101021411 in MI)

🟢
Initial NPI Registration & Enumeration June 27, 2014

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1891100954
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 27, 2014
Last Update: October 08, 2020
Sole Proprietor: Yes

Mailing Address

24 Frank Lloyd Wright Dr Ste J2000

Ann Arbor, MI 481059484

Phone: 7347476766

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.