Individual provider Active NPI

Christina Gibson Wisehart, MSW

  • Case Manager/Care Coordinator
  • Monroe, GA
National Provider Identifier
1568845022
Registry record updated Jul 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
515 San Dra Way
Monroe, GA 30656-8575
Phone
(770) 380-8114
NPI assigned
Jul 2, 2015
Last updated
Jul 2, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X GA Primary

Addresses

Primary practice location

515 San Dra Way
Monroe, GA 30656-8575

Mailing address

515 San Dra Way
Monroe, GA 30656-8575
Phone (770) 380-8114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435795200000",
    "number": "1568845022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 SAN DRA WAY",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306568575",
            "telephone_number": "770-380-8114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 SAN DRA WAY",
            "city": "MONROE",
            "state": "GA",
            "postal_code": "306568575",
            "telephone_number": "770-380-8114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISEHART",
        "first_name": "CHRISTINA",
        "middle_name": "GIBSON",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-02",
        "last_updated": "2015-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.