Trevor Kyle Wisniewski, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

DOS-2430 Issued in HI

Practice address

650 Joel Dr
Fort Campbell, KY 42223-8355

Phone

(270) 798-8400

NPI assigned

May 7, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in HI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1620345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784505600000",
    "number": "1811571623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422238355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 JOEL DR",
            "city": "FORT CAMPBELL",
            "state": "KY",
            "postal_code": "422238355",
            "telephone_number": "270-798-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISNIEWSKI",
        "first_name": "TREVOR",
        "middle_name": "KYLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-07",
        "last_updated": "2026-07-20",
        "certification_date": "2026-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "HI",
            "license": "DOS-2430",
            "primary": true
        },
        {
            "code": "2084F0202X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Forensic Psychiatry",
            "state": "HI",
            "license": "DOS-2430",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Lynne Winder, ATC
• Hans Martin Winebrenner
• Gerald Winger
• Nichole Winn, LPN
• Zachary Fielding Wiser, DO
• Mercedes Danielle Witt, PA-C
• Nicholas Woo, DO
• Altin Wood, CRNP
• Jamie Wood, RN
• Lavonda F Woods, PT

• Psychiatry Physician in Fort Campbell, KY
• Providers in Fort Campbell, KY by specialty
• Psychiatry Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2026; 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.