Individual provider Active NPI

Rodney Quinn Wisdom, D.C.

  • Chiropractor
  • Louisville, KY
National Provider Identifier
1982678140
Registry record updated Nov 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4078 Issued in KY
Practice address
5306 Bardstown Rd
Louisville, KY 40291-1931
Phone
(502) 499-7744
Fax
(502) 499-4928
NPI assigned
Feb 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4078 KY Primary

Addresses

Primary practice location

5306 Bardstown Rd
Louisville, KY 40291-1931

Mailing address

4214 Berkshire Ave
Louisville, KY 40220-1155
Phone (502) 499-7744

Other identifiers 5

IdentifierTypeStateIssuer
270696OtherKYPHCS
8735432OtherKYCIGNA
DD7594OtherKYRAILROAD MEDICARE GROUP #
7993OtherKYMEDICARE GROUP NUMBER
000000375026OtherKYBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050412000564 KY Practitioner - Chiropractic 4981641917 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wisdom Chiropractic Center IncGroup PAC ID 9133148463, 2 clinicians

Practice addresses (Care Compare)

7400 E Kilgus Cir
Crestwood, KY 40014-9447
Phone (502) 241-1499

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wisdom Chiropractic Center, Inc Chiropractor CurrentSince May 25, 2013 Accepting new patients
Anderson Physical Therapy LLC PastSince May 25, 2013 Accepting new patients
Evans Chiropractic PSC Past Accepting new patients

Locations

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

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196380800000",
    "number": "1982678140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 BERKSHIRE AVE",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402201155",
            "telephone_number": "502-499-7744",
            "fax_number": "502-499-4928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5306 BARDSTOWN RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402911931",
            "telephone_number": "502-499-7744",
            "fax_number": "502-499-4928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISDOM",
        "first_name": "RODNEY",
        "middle_name": "QUINN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-15",
        "last_updated": "2007-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "4078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "270696",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "8735432",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP #",
            "identifier": "DD7594",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "7993",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "000000375026",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.