KEVIN WISDOM (P.T.) – Physical Therapist, NPI 1063485670
Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
835 PHYSICAL THERAPIST IN PRIVATE PRACTICE in AR
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Provider Addresses for KEVIN WISDOM (P.T.)
1608, East Bowen Boulevard, Fayetteville, Washington County, Arkansas, 72703, United States
FAYETTEVILLE, AR 727021608
Phone: (479) 521-2752
Fax: (479) 444-6942
Type: Mailing
Ozark Orthopaedics Injury Clinic, 3317, North Wimberly Drive, North Hills Medical Park, Fayetteville, Washington County, Arkansas, 72703, United States
FAYETTEVILLE, AR 727034056
Phone: (479) 521-2752
Fax: (479) 444-6942
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-08-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040811000566 | I | Physical Therapist In Private Practice | AR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 1,324 | 158 | $0 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | 265 | 82 | $0 |
| 97530 | Therapy procedure using functional activities | 234 | 107 | $0 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 128 | 42 | $0 |
| 97016 | Application of blood vessel compression device | 101 | 34 | $0 |
Insurance plans in this area (ZIP 72702)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICAL THERAPY | AR | 97140 | Manual (physical) therapy techniques to 1 or more regions, each 15 minutes | 488 | 92 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Hand Surgery, Orthopedic Surgery | AR | |
| Orthopedic Surgery | AR | |
| Orthopedic Surgery | AR | |
| Physician Assistant | AR | |
| Occupational Therapist In Private Practice | AR | |
| Physical Therapist In Private Practice | AR | |
| - | AR | |
| Physical Therapist In Private Practice | AR | |
| Physical Therapist In Private Practice | AR | |
| Orthopedic Surgery | AR |
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