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

John David Wise, PA

Individual provider Physician Assistant · NPI 1093739724

John David Wise, PA is a Physician Assistant in Green Bay, Wisconsin. Qualified in 1996, 30 years ago. Practices with Bellin Memorial Hospital Inc, a 681-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois and Wisconsin.

Years since qualifying
30
Licensed in
IL, WI
In the registry since
2006
Specialties on file
2
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

2793 Lineville Rd
Green Bay, WI 54313-7152
Phone: (920) 496-4700
Fax: (920) 496-4705
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 7501 Grand Ave, Gurnee, IL 60031-1551 — (800) 323-8622

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 941 (WI)
Physician Assistant Taxonomy 363A00000X · Licence 085.009449 (IL)

Record details

NPI number1093739724
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 26, 2006
Last updated in NPPESApril 25, 2024
Certification dateApril 25, 2024
Mailing addressPo Box 19070, Prevea Health, Green Bay, WI 54307-9070

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice Bellin Memorial Hospital Inc — 681 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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