Individual provider Active NPI

Kennadi Wise, CNM

  • Advanced Practice Midwife
  • Rowlett, TX
National Provider Identifier
1316800709
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
1216853 Issued in TX
Practice address
9301 Lakeview Pkwy Ste 200
Rowlett, TX 75088-4458
Phone
(972) 475-7555
NPI assigned
Dec 3, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 1216853 TX Primary

Addresses

Primary practice location

9301 Lakeview Pkwy Ste 200
Rowlett, TX 75088-4458

Mailing address

9301 Lakeview Pkwy Ste 200
Rowlett, TX 75088-4458
Phone (972) 475-7555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260403000039 TX Practitioner - Certified Nurse Midwife (CNM) 0143705541 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
Other, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6000 Western Place
Suite 900
Fort Worth, TX 76161-0205

PO Box
Suite 961205
Fort Worth, TX 76161-0205

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
1216853TXMDAdvanced Practice Midwife

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1764720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1316800709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 LAKEVIEW PKWY STE 200",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750884458",
            "telephone_number": "972-475-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9301 LAKEVIEW PKWY STE 200",
            "city": "ROWLETT",
            "state": "TX",
            "postal_code": "750884458",
            "telephone_number": "972-475-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "KENNADI",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-03",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "TX",
            "license": "1216853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rowlett, TX

Sources for this page

Verify at the official NPI Registry.