Connor Wisniewski-Top, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11682R Issued in LA

Practice address

663 Jordan St
Shreveport, LA 71101-4748

Phone

(318) 222-8892

Fax

(318) 222-8893

NPI assigned

Aug 9, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Connor Wismiewski Other name

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• University Rehabilitation, LLC

  • Physical Therapist
  • Port Orange, FL
  • NPI 1811185291
  Medicare reassignment NPD
• Brewer Physical Therapy & Associates LLC

  • Physical Therapy Clinic/Center
  • Shreveport, LA
  • NPI 1477709681
  NPD
• Agilitas USA Inc

  • Physical Therapy Clinic/Center
  • Hixson, TN
  • NPI 1962417444

  Physical Therapist

  NPD
• Agilitas USA, Inc

  • Physical Therapy Clinic/Center
  • Chattanooga, TN
  • NPI 1518695436

  Physical Therapist

  NPD
• Benchmark Physical Therapy of NC, LLC

  • Physical Therapist
  • Leland, NC
  • NPI 1588189112
  NPD
• Benchmark Physical Therapy of North Carolina LLC

  • Physical Therapist
  • Ooltewah, TN
  • NPI 1356894604
  NPD
• Drayer Physical Therapy of North Carolina LLC

  • Physical Therapist
  • Raleigh, NC
  • NPI 1740605096
  NPD
• Select Physical Therapy Texas Limited Partnership

  • Physical Therapy Clinic/Center
  • Houston, TX
  • NPI 1356304323
  NPD (past)

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

{
    "created_epoch": "1660003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1558099507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "663 JORDAN ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014748",
            "telephone_number": "318-222-8892",
            "fax_number": "318-222-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "663 JORDAN ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014748",
            "telephone_number": "318-222-8892",
            "fax_number": "318-222-8893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIEWSKI-TOP",
        "first_name": "CONNOR",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-09",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P23108",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "LA",
            "license": "11682R",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT38752",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNOR",
            "last_name": "WISMIEWSKI",
            "credential": "PT, DPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rodney Wise, M.D.
• Sharetha Wise
• William R. Wise, MD
• Benjamin R. Wisenbaker, CRNA
• Morgan S. Wisenbaker
• Shila Withers
• Witte Family Dentistry, LLC
• Savanna Taelor Witthoeft
• WK Academic Medicine Clinic
• WK Adult Medicine Specialists

• Physical Therapist in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Physical Therapist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.