Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Blakely David Wise, PA

Individual provider Physician Assistant · NPI 1396201935

Blakely David Wise, PA is a Physician Assistant in Cornelius, North Carolina. Qualified in 2018, 8 years ago. Practices with Atrium Health North Market Network LLC, a 157-clinician group, works from 5 locations, accepts Medicare assignment and offers telehealth. Licensed in North Carolina.

Years since qualifying
8
Licensed in
NC
In the registry since
2019
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

20036 Zion Ave Ste 100
Cornelius, NC 28031-8435
Phone: (704) 801-7400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (4)

  • 1000 Blythe Blvd, Charlotte, NC 28203-5812 — (704) 355-2000
  • 1100 Blythe Blvd, Charlotte, NC 28203-5814 — (704) 355-4300
  • 201 E Grover St, Shelby, NC 28150-3917 — (980) 487-3000
  • 2301 Us Highway 74 W, Wadesboro, NC 28170-7554 — (704) 994-4500

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0010-08866 (NC)

Record details

NPI number1396201935
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 19, 2019
Last updated in NPPESSeptember 25, 2025
Certification dateApril 9, 2025
Mailing addressPo Box 19305, Charlotte, NC 28219-9305

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Atrium Health North Market Network Llc — 157 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations4 on file with Medicare

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