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Sharon Renee Wise , LPN, CDCA

Licensed Practical Nurse β€’ Mount Vernon, OH

Active NPI 1215461298 Individual Practitioner Female Practitioner
Practice location in NPPES

8402 Blackjack Rd
Mount Vernon, OH 430509193

Call 7403970442 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

8402 Blackjack Rd

Mount Vernon, OH 430509193

Telephone 7403970442
Organization at the Same NPPES Address or Phone
Moundbuilders Guidance Center, Inc. Facility NPI 1598723728

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2017

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Mount Vernon and Ohio

45 active clinicians are listed under Licensed Practical Nurse with a practice address in Mount Vernon, OH (12,649 in Ohio).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Mount Vernon

0% of these 45 clinicians have the CMS telehealth indicator.

0% of these 45 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2022-07-19
Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

License # reported to NPPES OH PN-090990

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Counselor - Addiction (Substance Use Disorder)

NUCC Taxonomy Code: 101YA0400X

License # reported to NPPES OH 160873
Case Manager/Care Coordinator

NUCC Taxonomy Code: 171M00000X

A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: State Medical Board of Ohio.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

2 listed
Sue Smith , MSRNC, CNS

Nurse Practitioner - Psychiatric/Mental Health

NPI 1609816446

MSRNC, Clinical Nurse Specialist

Tami Stephey , MS, APRN, PMHNP-BC

Nurse Practitioner - Psychiatric/Mental Health

NPI 1891207148

Master of Science, Advanced Practice Registered Nurse, Psychiatric-Mental Health Nurse Practitioner (Board Certified)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location July 08, 2022

Registered at 8402 BLACKJACK RD, MOUNT VERNON, OH 430509193 (Tel: 7403970442)

πŸ“
Updated Business Mailing Address July 08, 2022

Registered at 5818 COUNTY ROAD 93, MOUNT GILEAD, OH 433389684 (Tel: 5672418299)

πŸ‘€
Provider Name / Credentials Updated July 08, 2022

Recorded as SHARON WISE, LPN, CDCA

βœ…
NPI Profile Active April 17, 2017

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 17, 2017

Registered at 400 BOWMAN ST, MANSFIELD, OH 449031235 (Tel: 4195253525)

πŸ“
Business Mailing Address (Initial Record) April 17, 2017

Registered at 1579 SASSAFRAS DR, MANSFIELD, OH 449052376 (Tel: 4195712056)

πŸ‘€
Provider Name / Credentials (Initial Record) April 17, 2017

Recorded as SHARON GALLAGHER, LPN, CDCA, QMHS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 17, 2017

Counselor (license number reported to NPPES: OH 160873)

🟒
Initial NPI Registration & Enumeration April 17, 2017

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1215461298
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 17, 2017
Last Update: July 19, 2022
Sole Proprietor: Yes

Mailing Address

5818 County Road 93

Mount Gilead, OH 433389684

Phone: 5672418299

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.