Carissa Michelle Parker, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2013023363 Issued in MO

Practice address

1254 SE Century Dr
Lees Summit, MO 64081-3286

Phone

(480) 452-5302

NPI assigned

Jul 8, 2013

Last updated

Jan 23, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Carissa Michelle Wigand Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1373241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1194166116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 S ARROWHEAD DR",
            "address_2": "STE B",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556952",
            "telephone_number": "816-795-6999",
            "fax_number": "816-795-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1254 SE CENTURY DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640813286",
            "telephone_number": "480-452-5302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4900 S Arrowhead Dr",
            "address_2": "Ste B",
            "address_purpose": "LOCATION",
            "city": "Independence",
            "state": "MO",
            "postal_code": "640556952",
            "country_code": "US",
            "telephone_number": "816-795-6999",
            "fax_number": "816-795-3366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKER",
        "first_name": "CARISSA",
        "middle_name": "MICHELLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-08",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2013023363",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MO",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST",
            "identifier": "1194166116",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194166116",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARISSA",
            "last_name": "WIGAND",
            "middle_name": "MICHELLE",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mary Beth Panek, LCSW
• Barbara Panigot, RN
• Casey Paris
• Laura Parisi, MD
• Natalie Parke
• Kelli G Parker, CRNA
• Rosanne Marie Parks, RN
• Heather Louise Parrish, NURSE PRACTITIONER
• Jordan Parrish, PT, DPT
• Rebecca Parshall, RD, LD

• Physical Therapist in Lee's Summit, MO
• Providers in Lee's Summit, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.