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

Kevin Brantley Wise, MD

Individual provider Surgery Physician · NPI 1427344233

Kevin Brantley Wise, MD is a General Surgery in Millcreek, Utah. Graduated from Vanderbilt University School of Medicine in 2011, 15 years ago. Practices with Intensive Care Consortium Inc, a 483-clinician group and accepts Medicare assignment. Licensed in Minnesota, Texas and Utah.

Years since qualifying
15
Trained at
Vanderbilt University School of Medicine
Licensed in
MN, TX, UT
In the registry since
2011
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

1200 E 3900 S Ste 4E
Millcreek, UT 84124-1300
Phone: (385) 347-3773
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 13005654-1205 (UT)
Surgery Physician Taxonomy 208600000X · Licence 55513 (MN)
Surgical Critical Care Physician Taxonomy 2086S0102X · Licence 13005654-1205 (UT)
Trauma Surgery Physician Taxonomy 2086S0127X · Licence Q8190 (TX)

Record details

NPI number1427344233
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 21, 2011
Last updated in NPPESMarch 30, 2023
Certification dateMarch 30, 2023
Mailing address1220 E 3900 S Ste 4e, Millcreek, UT 84124-1343

Medicare enrollment

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

Medicare specialtyGENERAL SURGERY
Medical schoolVANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Graduated 2011 (15 years in practice)
Group practice Intensive Care Consortium Inc — 483 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare