Dorothy Marymay Wisdom, PT,DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1071686 Issued in TX

Practice address

3023 Marina Bay Dr Ste 105
League City, TX 77573-2882

Phone

(281) 549-6404

Fax

(832) 864-2580

NPI assigned

Feb 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Ortholonestar, PLLC

  • Orthopaedic Surgery Physician
  • Houston, TX
  • NPI 1942860176
  NPD (past)
• Webster Surgical Specialty Hospital, LLC

  • General Acute Care Hospital
  • Webster, TX
  • NPI 1285699835
  NPD (past)

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

{
    "created_epoch": "1581552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1760015150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3023 MARINA BAY DR STE 105",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775732882",
            "telephone_number": "281-549-6404",
            "fax_number": "832-864-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 MARINA BAY DR STE 105",
            "city": "LEAGUE CITY",
            "state": "TX",
            "postal_code": "775732882",
            "telephone_number": "281-549-6404",
            "fax_number": "832-864-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISDOM",
        "first_name": "DOROTHY",
        "middle_name": "MARYMAY",
        "credential": "PT,DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-13",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1071686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LISCENSE",
            "identifier": "1071686",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chase Morgan Wilson, MD
• Melanie Elaine Wilson
• Trevor Wilson, PT, DPT
• Emily W Winter, RN, CRNA
• Andrea Winters, LPC-ASSOCIATE
• Nicholas Matthew Wisdom, PH.D.
• Jennifer Withey, MSACN
• Terri Wittman
• Airianna Marie Wittwer
• Kristin Louise Wolfe, PSY.D.

• Physical Therapist in League City, TX
• Providers in League City, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.