Individual provider Active NPI

John Michael Wubbenhorst Sr., MS

  • Clinical Psychologist
  • Kansas City, MO
National Provider Identifier
1245226745
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY00348 Issued in MO
Practice address
3100 Broadway St
Suite 1104
Kansas City, MO 64111-2658
Phone
(816) 753-3333
Fax
(616) 753-7744
NPI assigned
Sep 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PY00348 MO
Clinical Psychologist 103TC0700X PY00348 MO Primary
Health Service Psychologist 103TH0100X PY00348 MO

Addresses

Primary practice location

3100 Broadway St
Suite 1104
Kansas City, MO 64111-2658

Mailing address

3100 Broadway St
Suite 1104
Kansas City, MO 64111-2658
Phone (816) 753-3333

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
Master of Science

State licenses

LicenseStateTypeSpecialty
PY00348MOMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Wubbenhorst & Wubbenhorst, Inc. Psychologist Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1245226745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 BROADWAY ST",
            "address_2": "SUITE 1104",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112658",
            "telephone_number": "816-753-3333",
            "fax_number": "616-753-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 BROADWAY ST",
            "address_2": "SUITE 1104",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641112658",
            "telephone_number": "816-753-3333",
            "fax_number": "616-753-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WUBBENHORST",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "PY00348",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "PY00348",
            "primary": true
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MO",
            "license": "PY00348",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.