Jeremy Wiseman, MPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

004213 Issued in KY

Practice address

9400 Williamsburg PLZ
Suite 100
Louisville, KY 40222-5093

Phone

(502) 412-4486

Fax

(502) 412-4490

NPI assigned

Jul 12, 2006

Last updated

Sep 19, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

SN Kentuckiana Rehab, LLCGroup PAC ID 1254671464, 339 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• SN Kentuckiana Rehab, LLC

  dba KORT Physical Therapy

  • Rehabilitation Clinic/Center
  • Louisville, KY
  • NPI 1609349018
  Medicare reassignment Care Compare group
• Physical Therapy Alliance, LLC

  dba Star Physical Therapy

  • Physical Therapist
  • Louisville, KY
  • NPI 1497785216
  NPD (past)
• SN Kentuckiana Rehab, LLC

  dba KORT Physical Therapy

  • Rehabilitation Clinic/Center
  • Louisville, KY
  • NPI 1235602616
  NPD (past)

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190160000000",
    "number": "1346265303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9400 WILLIAMSBURG PLZ",
            "address_2": "SUITE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402225093",
            "telephone_number": "502-412-4486",
            "fax_number": "502-412-4490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 WILLIAMSBURG PLZ",
            "address_2": "SUITE 100",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402225093",
            "telephone_number": "502-412-4486",
            "fax_number": "502-412-4490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEMAN",
        "first_name": "JEREMY",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "004213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Jo Wise, M.D.
• Quentin Virgil Wise
• Samantha Wambles Wise, LPTA
• Tiaka Wise
• Wilbert John Wise III, PT, DPT
• Nicole Wiseman
• Thomas Mitchell Wiseman, DPT
• Courtney Lee Wisher, SLP
• Frank Wishnia
• Meggin Wishon

• Physical Therapist in Louisville, KY
• Providers in Louisville, KY by specialty
• Physical Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.