Individual provider Active NPI

Christina Shuman Wise, M.D.

  • Psychiatry Physician
  • Covington, KY
National Provider Identifier
1730342635
Registry record updated Feb 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
45447 Issued in KY
Practice address
20 West 18TH Street
Covington, KY 41011-3329
Phone
(859) 757-0717
Fax
(859) 331-2425
NPI assigned
Jul 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Preventive Medicine) Physician 2083A0300X 45447 KY
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 45447 KY
Psychiatry Physician 2084P0800X TP315 KY
Psychiatry Physician 2084P0800X 099222 OH
Child & Adolescent Psychiatry Physician 2084P0804X 099222 OH
Psychiatry Physician 2084P0800X 45447 KY Primary

Addresses

Primary practice location

20 West 18TH Street
Covington, KY 41011-3329

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 301-5901

Other practice location 1

11161 Kenwood Rd
Building #6
Blue Ash, OH 45242
Phone (513) 769-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131022001362 KY Practitioner - Addiction MedicinePractitioner - Psychiatry 5294960506 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Addiction MedicineAlso: Psychiatry
Education
Vanderbilt University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

20 W 18TH St
Covington, KY 41011-3329
Phone (859) 757-0717

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
45447KYMDAddiction Medicine (Psychiatry & Neurology) Physician
099222OHMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc CurrentSince Oct 1, 2018 Accepting new patients
Summit Medical Group, Inc. CurrentSince Oct 1, 2018 Accepting new patients

Locations

20 W 18th St
Covington, KY 41011
Phone (859) 757-0717

351 Centre View Blvd
Crestview Hills, KY 41017
Phone (859) 572-2000

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Interoperability endpoints

  • Direct secure messaging: cwise240603@direct-prd.stelizabeth.com

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": "1215648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1730342635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-301-5901",
            "fax_number": "859-301-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 WEST 18TH STREET",
            "city": "COVINGTON",
            "state": "KY",
            "postal_code": "410113329",
            "telephone_number": "859-757-0717",
            "fax_number": "859-331-2425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11161 Kenwood Rd",
            "address_2": "Building #6",
            "address_purpose": "LOCATION",
            "city": "Blue Ash",
            "state": "OH",
            "postal_code": "45242",
            "country_code": "US",
            "telephone_number": "513-769-4600",
            "fax_number": "513-769-0304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WISE",
        "first_name": "CHRISTINA",
        "middle_name": "SHUMAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-10",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "KY",
            "license": "45447",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "KY",
            "license": "45447",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "TP315",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "OH",
            "license": "099222",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OH",
            "license": "099222",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "45447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, KY

Sources for this page

Verify at the official NPI Registry.