DR. SARA E WISE PHD
Complete NPI Record 1639776313
Psychologist - Clinical in Iowa City, IA

NPI Status: Active since October 05, 2020

Contact Information

200 HAWKINS DR
IOWA CITY, IA
ZIP 52242
Phone: (319) 353-6314

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  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Name Prefix Text
  7. Provider Credential Text
  8. Provider First Line Business Mailing Address
  9. Provider Business Mailing Address City Name
  10. Provider Business Mailing Address State Name
  11. Provider Business Mailing Address Postal Code
  12. Provider Business Mailing Address Country Code If outside U S
  13. Provider Business Mailing Address Telephone Number
  14. Provider First Line Business Practice Location Address
  15. Provider Business Practice Location Address City Name
  16. Provider Business Practice Location Address State Name
  17. Provider Business Practice Location Address Postal Code
  18. Provider Business Practice Location Address Country Code If outside U S
  19. Provider Business Practice Location Address Telephone Number
  20. Provider Enumeration Date
  21. Last Update Date
  22. Provider Gender Code
  23. Healthcare Provider Taxonomy Code 1
  24. Provider License Number 1
  25. Provider License Number State Code 1
  26. Healthcare Provider Primary Taxonomy Switch 1
  27. Healthcare Provider Taxonomy Code 2
  28. Healthcare Provider Primary Taxonomy Switch 2
  29. Healthcare Provider Taxonomy Code 3
  30. Provider License Number 3
  31. Provider License Number State Code 3
  32. Healthcare Provider Primary Taxonomy Switch 3
  33. Healthcare Provider Taxonomy Code 4
  34. Provider License Number 4
  35. Provider License Number State Code 4
  36. Healthcare Provider Primary Taxonomy Switch 4
  37. Healthcare Provider Taxonomy Code 5
  38. Provider License Number 5
  39. Provider License Number State Code 5
  40. Healthcare Provider Primary Taxonomy Switch 5
  41. Healthcare Provider Taxonomy Code 6
  42. Provider License Number 6
  43. Provider License Number State Code 6
  44. Healthcare Provider Primary Taxonomy Switch 6
  45. Healthcare Provider Taxonomy Code 7
  46. Provider License Number 7
  47. Provider License Number State Code 7
  48. Healthcare Provider Primary Taxonomy Switch 7
  49. Healthcare Provider Taxonomy Code 8
  50. Provider License Number 8
  51. Provider License Number State Code 8
  52. Healthcare Provider Primary Taxonomy Switch 8
  53. Healthcare Provider Taxonomy Code 9
  54. Provider License Number 9
  55. Provider License Number State Code 9
  56. Healthcare Provider Primary Taxonomy Switch 9
  57. Healthcare Provider Taxonomy Code 10
  58. Provider License Number 10
  59. Provider License Number State Code 10
  60. Healthcare Provider Primary Taxonomy Switch 10
  61. Healthcare Provider Taxonomy Code 11
  62. Provider License Number 11
  63. Provider License Number State Code 11
  64. Healthcare Provider Primary Taxonomy Switch 11
  65. Healthcare Provider Taxonomy Code 12
  66. Provider License Number 12
  67. Provider License Number State Code 12
  68. Healthcare Provider Primary Taxonomy Switch 12
  69. Is Sole Proprietor
  70. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1639776313. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1639776313
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 1
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: SARA
The first name of the provider, if the provider is an individual.
Provider Middle Name: E
The middle name of the provider, if the provider is an individual.
Provider Name Prefix Text: DR.
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Credential Text: PHD
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address: 200 HAWKINS DR
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: IOWA CITY
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: IA
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 522421009
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 3193536314
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Practice Location Address: 200 HAWKINS DR
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: IOWA CITY
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: IA
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 522421009
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 3193536314
The telephone number associated with the location address of the provider being identified.
Provider Enumeration Date: 10/5/2020
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 11/9/2021
The date that a record was last updated or changed.
Provider Gender Code: F
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 103T00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 105860
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: IA
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: N
Healthcare Provider Taxonomy Code 2: 103T00000X
Healthcare Provider Primary Taxonomy Switch 2: N
Healthcare Provider Taxonomy Code 3: 103TA0700X
Provider License Number 3: 105860
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 3: IA
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 3: N
Healthcare Provider Taxonomy Code 4: 103TB0200X
Provider License Number 4: 105860
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 4: IA
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 4: N
Healthcare Provider Taxonomy Code 5: 103TC1900X
Provider License Number 5: 105860
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 5: IA
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 5: N
Healthcare Provider Taxonomy Code 6: 103TC2200X
Provider License Number 6: 105860
Provider License Number State Code 6: IA
Healthcare Provider Primary Taxonomy Switch 6: N
Healthcare Provider Taxonomy Code 7: 103TF0000X
Provider License Number 7: 105860
Provider License Number State Code 7: IA
Healthcare Provider Primary Taxonomy Switch 7: N
Healthcare Provider Taxonomy Code 8: 103TH0100X
Provider License Number 8: 105860
Provider License Number State Code 8: IA
Healthcare Provider Primary Taxonomy Switch 8: N
Healthcare Provider Taxonomy Code 9: 103TM1800X
Provider License Number 9: 105860
Provider License Number State Code 9: IA
Healthcare Provider Primary Taxonomy Switch 9: N
Healthcare Provider Taxonomy Code 10: 103TP2701X
Provider License Number 10: 105860
Provider License Number State Code 10: IA
Healthcare Provider Primary Taxonomy Switch 10: N
Healthcare Provider Taxonomy Code 11: 103TS0200X
Provider License Number 11: 105860
Provider License Number State Code 11: IA
Healthcare Provider Primary Taxonomy Switch 11: N
Healthcare Provider Taxonomy Code 12: 103TC0700X
Provider License Number 12: 105860
Provider License Number State Code 12: IA
Healthcare Provider Primary Taxonomy Switch 12: Y
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No
NPI Certification Date: 11/9/2021