Individual provider Active NPI

Wendy Ann Machalicek, PH.D., BCBA-D

  • Behavior Analyst
  • Springfield, OR
National Provider Identifier
1073998050
Registry record updated Jul 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
10167657 Issued in OR
Practice address
37080 Wallace Creek Rd
Springfield, OR 97478-9575
Phone
(608) 320-6028
NPI assigned
Jul 20, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 10167657 OR Primary

Addresses

Primary practice location

37080 Wallace Creek Rd
Springfield, OR 97478-9575

Mailing address

37080 Wallace Creek Rd
Springfield, OR 97478-9575
Phone (608) 320-6028

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
10167657ORMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1437350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437350400000",
    "number": "1073998050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37080 WALLACE CREEK RD",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974789575",
            "telephone_number": "608-320-6028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37080 WALLACE CREEK RD",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974789575",
            "telephone_number": "608-320-6028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACHALICEK",
        "first_name": "WENDY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PH.D., BCBA-D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-20",
        "last_updated": "2015-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "OR",
            "license": "10167657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.