{"npi":"1790740892","type":"NPI-1","status":"active","name":{"display":"Todd Wise MD","other":[],"first":"TODD","last":"WISE","middle":"V","credential":"MD"},"specialty":{"primary_taxonomy":"207R00000X","primary_taxonomy_description":"Internal Medicine","slug":"internal-medicine","schema_org_specialty":"Internal","all":[{"code":"207R00000X","description":"Internal Medicine","primary":false,"state":"WA","license":"MD60003713"},{"code":"207R00000X","description":"Internal Medicine","primary":false,"state":"TX","license":"S8264"},{"code":"207R00000X","description":"Internal Medicine","primary":true,"state":"OR","license":"MD21898"}]},"addresses":[{"purpose":"LOCATION","street_1":"1321 NE 99TH AVE STE 100","city":"PORTLAND","state":"OR","postal_code":"972209437","country_code":"US","phone":"5038936670"},{"purpose":"MAILING","street_1":"PO BOX 3158","city":"PORTLAND","state":"OR","postal_code":"972083158","country_code":"US"}],"license":{"state":"OR","number":"MD21898"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"287272","state":"OR","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"I20230721003417","type_code":"14-11","type_desc":"PRACTITIONER - INTERNAL MEDICINE","state":"TN","pac_id":"8921131616"}]},"enumeration_date":"2006-04-20","last_updated":"2024-04-02","_meta":{"source":"NPPES","snapshot_date":"2024-04-02","doc_url":"https://findmynpi.com/api"}}