Organization Active NPI

Wisdom Chiropractic Center, Inc

  • Chiropractor
  • Crestwood, KY
National Provider Identifier
1770705378
Registry record updated Mar 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4139 Issued in KY
Legal business name
WISDOM CHIROPRACTIC CENTER, INC
Practice address
7400 E Kilgus Cir
Crestwood, KY 40014-9447
Phone
(502) 241-1499
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2018

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

Authorized official

Name
Dr. Kathleen Wisdom, D.C.NPI 1316005937
Title
President
Phone
(502) 241-1499

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 4139 KY Primary

Addresses

Primary practice location

7400 E Kilgus Cir
Crestwood, KY 40014-9447

Mailing address

7400 East Kilgus Circle
Crestwood, KY 40014
Phone (502) 241-1499

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051116000501 KY Part B Supplier - Clinic/Group Practice 9133148463 Receives reassigned benefits from 2 practitioners
Practice locations: Crestwood, KY

National Provider Directory

National Provider Directory

Locations

7400 E Kilgus Cir
Crestwood, KY 40014
Phone (502) 241-1499

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522281600000",
    "number": "1770705378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 EAST KILGUS CIRCLE",
            "city": "CRESTWOOD",
            "state": "KY",
            "postal_code": "40014",
            "telephone_number": "502-241-1499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 E KILGUS CIR",
            "city": "CRESTWOOD",
            "state": "KY",
            "postal_code": "400149447",
            "telephone_number": "502-241-1499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WISDOM CHIROPRACTIC CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2018-03-29",
        "status": "A",
        "authorized_official_last_name": "WISDOM",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-241-1499",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestwood, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; 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.