ELIZABETH ANN MARIE WISE PA-C
NPI 1104419472
Physician Assistant in Fayetteville, NC

Q: What is Elizabeth Wise's NPI number?

The NPI number for Elizabeth Wise is 1104419472. It was assigned to this individual provider in the NPPES registry on February 17, 2021.

Q: What is Elizabeth Wise's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Elizabeth Wise was last updated on May 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 17, 2021PECOS Enrolled

556 SANDHURST DR, FAYETTEVILLE, NC 28304(910) 483-2646 Get Directions Write a Review

NPPES record last updated: May 5, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 5, 2026, Feb 6, 2026, Jul 1, 2025 and 2 more (5 updates tracked since 2021).

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About Elizabeth Ann Marie Wise Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ELIZABETH ANN MARIE WISE PA-C (NPI 1104419472) is an individual physician assistant in Fayetteville, North Carolina, licensed in North Carolina (001011052) and active in the NPI registry since February 2021. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1104419472

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameELIZABETH ANN MARIE WISECredential: PA-C

Location Address556 SANDHURST DRFayetteville, NC 28304-4426

Mailing Address9225 Main StGodwin, NC 28344-8361 · (910) 723-1072

Phone(910) 483-2646

Sole ProprietorNo

Enumeration DateFebruary 17, 2021

Last NPPES UpdateMay 5, 20265 updates tracked since enumeration

NPPES CertifiedMay 5, 2026

✔ NPI 1104419472 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in NC · 001011052

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

556 SANDHURST DR, Fayetteville, NC 28304

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Secondary Practice Locations 2

Location 17118 Main StWade, NC 28395-9749 · Phone (910) 483-6694

Location 21095 N Bragg Blvd Ste 104Spring Lake, NC 28390-3307 · Phone (910) 615-6949 · Fax (910) 615-9761

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Elizabeth Ann Marie Wise Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28304 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KELSEY HARMON PA

Physician Assistant