Kristina Wise

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34008004A Issued in IN

Practice address

203 W Wayne St Ste 317
Fort Wayne, IN 46802

Phone

(260) 333-9703

NPI assigned

Nov 29, 2006

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 IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Alliance Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fort Wayne, IN
  • NPI 1316556848
  Medicare reassignment NPD
• Allen County Drug and Alcohol Consortium, Inc.

  • Clinical Social Worker
  • Fort Wayne, IN
  • NPI 1164133070
  NPD Authorized official
• Alliance Health Centers Inc.

  • Federally Qualified Health Center (FQHC)
  • Marion, IN
  • NPI 1013880913
  NPD
• Ally Counseling & Consulting, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Wayne, IN
  • NPI 1588167860
  NPD (past)
• June Wellness LLC

  • Clinical Social Worker
  • Fort Wayne, IN
  • NPI 1801530365
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528243200000",
    "number": "1720155492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 W WAYNE ST STE 317",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468023610",
            "telephone_number": "260-333-9703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 W WAYNE ST STE 317",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "46802",
            "telephone_number": "260-333-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISE",
        "first_name": "KRISTINA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2018-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008004A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelli Y Winther, NP
• Sydney Winther, RDN, LD
• Allison Morgan Wintin
• Wisconsin Vision, Inc
• Wise Choices, Inc
• Marguerite Kay Wise, MS
• Patrick Joseph Wise, DO
• Sondra Ann Wise, 17001471A
• Britney L Wiseman
• Sarah Catherine Wisser, OD

• Clinical Social Worker in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.