Individual provider Active NPI

Christina Wisdom, PT

  • Physical Therapist
  • Kansas City, MO
National Provider Identifier
1548627946
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2008032044 Issued in MO
Practice address
601 E 63Rd St Ste 230
Kansas City, MO 64110-3303
Phone
(816) 569-2802
Fax
(816) 569-5436
NPI assigned
Jan 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 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 11-03624 KS
Physical Therapist 225100000X 2008032044 MO Primary

Addresses

Primary practice location

601 E 63Rd St Ste 230
Kansas City, MO 64110-3303

Mailing address

4700 Belleview Ave
Suite 415
Kansas City, MO 64112-1378
Phone (816) 569-2802

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160226001873 MO Practitioner - Physical Therapist in Private Practice 5395040463 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Foundational Concepts IncGroup PAC ID 2961648126, 18 clinicians

Practice addresses (Care Compare)

601 E 63Rd St
Ste. 230
Kansas City, MO 64110-3339
Phone (816) 569-2802

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11-03624KSMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Jennifer Worth MSW, LCSW, LLC PastSince Oct 13, 2021 Accepting new patients

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": "1452816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1548627946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 BELLEVIEW AVE",
            "address_2": "SUITE 415",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641121378",
            "telephone_number": "816-569-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E 63RD ST STE 230",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641103303",
            "telephone_number": "816-569-2802",
            "fax_number": "816-569-5436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISDOM",
        "first_name": "CHRISTINA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-15",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KS",
            "license": "11-03624",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2008032044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.