JORDAN M WISNER PHD
NPI 1255847786
Psychologist in Boise, ID

Active since December 20, 2017PECOS Enrolled
444 W FORT ST FL 2, BOISE, ID 83702(208) 422-1018 Get Directions Write a Review

NPPES record last updated: August 30, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 30, 2023, Dec 20, 2017 (2 updates tracked since 2017).

About Jordan M Wisner Phd NPPES

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

JORDAN M WISNER PHD (NPI 1255847786) is an individual psychologist in Boise, Idaho and active in the NPI registry since December 2017. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1255847786
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameJORDAN M WISNERCredential: PHD
Location Address444 W FORT ST FL 2Boise, ID 83702-4535
Mailing Address444 W Fort St Fl 2Boise, ID 83702-4535 · (208) 422-1018
Sole ProprietorNo
Enumeration DateDecember 20, 2017
Last NPPES UpdateAugust 30, 20232 updates tracked since enumeration
NPPES CertifiedAugust 30, 2023
NPI 1255847786 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
444 W FORT ST FL 2, Boise, ID 83702

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Jordan M Wisner Phd 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.

Other Providers at the Same Location NPPES 20

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

Psychologist (Clinical)
444 W FORT ST FL 2
BOISE, ID 83702
Social Worker (Clinical)
444 W FORT ST FL 2
BOISE, ID 83702
Psychologist (Clinical)
444 W FORT ST FL 2
BOISE, ID 83702
Social Worker (Clinical)
444 W FORT ST FL 2
BOISE, ID 83702
Nurse Practitioner (Family)
444 W FORT ST FL 2
BOISE, ID 83702
Physician Assistant
444 W FORT ST FL 2
BOISE, ID 83702
Psychologist
444 W FORT ST FL 2
BOISE, ID 83702
Nurse Practitioner (Family)
444 W FORT ST FL 2
BOISE, ID 83702

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jordan Wisner's NPI number?

The NPI number for Jordan Wisner is 1255847786. It was assigned to this individual provider in the NPPES registry on December 20, 2017.

Where is Jordan Wisner located?

Jordan Wisner practices at 444 W Fort St Fl 2, Boise, ID 83702. The listed phone number is (208) 422-1018.

What is Jordan Wisner's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Jordan Wisner enrolled in Medicare?

Yes. Jordan Wisner is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jordan Wisner was last updated on August 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.