Jessica Danielle Keala Wise, DNP, CNM, PMHNP in Charlotte, NC

Jessica Danielle Keala Wise, DNP, CNM, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Charlotte, North Carolina. She graduated from nursing school in 2017 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Pediatric And Family Behavioral Health Pllc and her current practice location is 4412 Park Rd Ste B, Charlotte, North Carolina. You can reach out to her office (for appointments etc.) via phone at (617) 379-0496.

Jessica Danielle Keala Wise is licensed to practice in North Carolina (license number 5020240) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1912413428.

Contact Information

	Jessica Danielle Keala Wise, DNP, CNM, PMHNP
	4412 Park Rd Ste B, Charlotte, NC 28209-3130
	(617) 379-0496
	Not Available

Map and Direction

Provider's Profile

Full Name	Jessica Danielle Keala Wise
Gender	Female
Speciality	Nurse Practitioner
Experience	9 Years
Location	4412 Park Rd Ste B, Charlotte, North Carolina
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Jessica Danielle Keala Wise graduated from nursing school in 2017

NPI Data:

NPI Number: 1912413428
Provider Enumeration Date: 12/19/2017
Last Update Date: 02/10/2026

Medicare PECOS Information:

PECOS PAC ID: 0648535815
Enrollment ID: I20241203004069

Medical Identifiers

Medical identifiers for Jessica Danielle Keala Wise such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1912413428	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	5020240 (North Carolina)	Primary
367A00000X	Advanced Practice Midwife	(* (Not Available))	Secondary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Pediatric And Family Behavioral Health Pllc	6608287909	6

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Jessica Danielle Keala Wise allows following entities to bill medicare on her behalf.

Entity Name	Carolinas Medical Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1275774333 PECOS PAC ID: 4789597477 Enrollment ID: O20031110000116

Entity Name	Pediatric And Family Behavioral Health Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1700385507 PECOS PAC ID: 6608287909 Enrollment ID: O20201117002217

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jessica Danielle Keala Wise is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Jessica Danielle Keala Wise, DNP, CNM, PMHNP 4412 Park Rd, Charlotte, NC 28209-3130 Ph: (617) 379-0496	Jessica Danielle Keala Wise, DNP, CNM, PMHNP 4412 Park Rd Ste B, Charlotte, NC 28209-3130 Ph: (617) 379-0496

Reviews and Comments

Nurse Practitioner Nurses in Charlotte, NC

Melissa E Jesse, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2236 Shenandoah Ave, Charlotte, NC 28205 Phone: 704-999-9857
Mrs. Adrienne Dunlap Lane, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 200 Hawthorne Ln, Charlotte, NC 28204 Phone: 704-384-4109
Melissa Renee Flood, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1225 Harding Pl, Ste 5100, Charlotte, NC 28204 Phone: 704-355-8850
Anna Philbeck Burgess, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4135 Southstream Blvd, Charlotte, NC 28217 Phone: 704-631-1200
Stephanie Dawn Ferlic, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 6900 Farmingdale Dr, Charlotte, NC 28212 Phone: 704-910-5810
Brooke Alyssa Davis, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2711 Randolph Rd Ste 400, Charlotte, NC 28207 Phone: 704-342-1900 Fax: 704-377-0353
Solim Tchedre, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1900 Randolph Rd Ste 800, Charlotte, NC 28207 Phone: 704-384-1246 Fax: 704-384-6072

Jessica Danielle Keala Wise, DNP, CNM, PMHNP - Medicare Nurse Practitioner in Charlotte, NC