JUSTIN M WISEMAN (PSY.D.) – Clinical Psychologist, NPI 1073159539

Clinical Psychologist

JUSTIN M WISEMAN (PSY.D.) is a healthcare provider. based in Fulton, Missouri. specializing in Clinical Psychologist. They hold the professional credentials PSY.D.. They hold a License No. 2018037238 (MO). The NPI Number for JUSTIN M WISEMAN (PSY.D.) is 1073159539

Main info

Male

8 Years Of Experience

Accepts Medicare Assignment

Name

JUSTIN M WISEMAN (PSY.D.)

NPI

1073159539

Phone

(573) 592-4100

Address

600 E 5TH ST

Enumeration Date

20 November 2019

Last Update Date

24 March 2021

Doctor Profile

Medical School Name

OTHER

Secondary Phone

5735924100

Graduation Year

2018 (8 years ago)

PAC ID

3577998111

Group Practice PAC ID

1456254226

Professional Enrollment ID

I20200108002852

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience36

Completeness75

Years active:6State licenses:1Digital endpointsOther names

Provider Addresses for JUSTIN M WISEMAN (PSY.D.)

600 E 5TH ST
FULTON, MO 652511753
Phone: (573) 592-4100
Type: Mailing
303 N Stadium Blvd Ste 200
Columbia, MO 652031429
Phone: (314) 255-9594
Type: Location
600 E 5th St
Fulton, MO 652511753
Phone: (573) 592-4100
Type: Location
1300 Metropolitan Ave
Leavenworth, KS 660481254
Phone: (314) 255-9594
Type: Location
401 E 19TH ST APT 1405
KANSAS CITY, MO 641081791
Phone: (314) 255-9594
Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

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Medicare Utilization (FFS)

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No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 65251)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 1456254226View full group profile

Name	Specialty	State
MRS. BRANDY BACZWASKI (M.A.)	-	MO
DR. ALICIA D THOMPSON (M.D.)	P S Y C H I A T R Y	OK
JAMESY CHARLES SMITH (D.O.)	Family Practice	MO
DR. COLLEEN TERESA LOEHR (M.D.)	P S Y C H I A T R Y	MO
BRIDGET K MCCOY (MD)	P S Y C H I A T R Y	MO
KEVIN CARPENTER	-	MO
MARK A. FELCHLIA	-	MO
Unknown Individual	-	MO
DR. NIRMALA KURIAN (M.D.)	P S Y C H I A T R Y	MO
ANDREW WHITE (DNP, FNP-C)	Nurse Practitioner	MO