Individual provider Active NPI

Kirstin Kuo-Tung Wu, DPT

  • Physical Therapist
  • Roxboro, NC
National Provider Identifier
1538795612
Registry record updated Aug 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP048092T Issued in NC
Practice address
615 Ridge Rd
Roxboro, NC 27573-4629
Phone
(336) 503-5774
NPI assigned
Mar 20, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070028791 IL
Physical Therapist 225100000X CP048092T NC Primary

Addresses

Primary practice location

615 Ridge Rd
Roxboro, NC 27573-4629

Mailing address

615 Ridge Rd
Roxboro, NC 27573-4629
Phone (336) 503-5774

Other practice location 1

2540 N Lincoln Ave
Chicago, IL 60614-2314
Phone (877) 632-6637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250407002332 IL Practitioner - Physical Therapist in Private Practice 6002246196 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
045534NYMDPharmacist
070028791ILMDPhysical Therapist
CP048092TNCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomidwest, PLLC Physical Therapist CurrentSince Mar 24, 2025 Accepting new patients
Orthomidwest, PLLC CurrentSince Mar 24, 2025 Accepting new patients

Locations

770 Beloit Rd
Belvidere, IL 61008
Phone (815) 847-7060

2540 N Lincoln Ave
Chicago, IL 60614
Phone (708) 492-5740

Organizations & group practices 2

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": "1584662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754092800000",
    "number": "1538795612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 RIDGE RD",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275734629",
            "telephone_number": "336-503-5774",
            "fax_number": "336-503-5625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 RIDGE RD",
            "city": "ROXBORO",
            "state": "NC",
            "postal_code": "275734629",
            "telephone_number": "336-503-5774"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2540 N Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606142314",
            "country_code": "US",
            "telephone_number": "877-632-6637",
            "fax_number": "708-409-5179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WU",
        "first_name": "KIRSTIN",
        "middle_name": "KUO-TUNG",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-20",
        "last_updated": "2025-08-02",
        "certification_date": "2025-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070028791",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "CP048092T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.