Active NPI
Kimberly Jo Wheelock, LCSW
- Clinical Social Worker
- Quincy, IL
National Provider Identifier
1225512361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.020630
- Practice address
- 915 Vermont St
Quincy, IL 62301-3049 - Phone
- (217) 222-8254
- Fax
- (217) 222-4512
- NPI assigned
- Sep 24, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.020630 | IL | Primary |
Addresses
Primary practice location
915 Vermont St
Quincy, IL 62301-3049
Mailing address
915 Vermont St
Quincy, IL 62301-3049
Phone (217) 222-8254
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.020630 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537747200000",
"number": "1225512361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "915 VERMONT ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623013049",
"telephone_number": "217-222-8254",
"fax_number": "217-222-4512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "915 VERMONT ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623013049",
"telephone_number": "217-222-8254",
"fax_number": "217-222-4512"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHEELOCK",
"first_name": "KIMBERLY",
"middle_name": "JO",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-09-24",
"last_updated": "2018-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.020630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Quincy, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.