Individual provider Active NPI

Maggie Wieberg

  • Behavior Analyst
  • Jefferson City, MO
National Provider Identifier
1255248795
Registry record updated Aug 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
2026041118 Issued in MO
Practice address
2707 W Edgewood Dr
Jefferson City, MO 65109-5888
Phone
(573) 680-5586
NPI assigned
Aug 27, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2026

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 2026041118 MO Primary

Addresses

Primary practice location

2707 W Edgewood Dr
Jefferson City, MO 65109-5888

Mailing address

1405 Karen Dr Apt C
Jefferson City, MO 65101-4279
Phone (573) 680-5586

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1787788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787788800000",
    "number": "1255248795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 KAREN DR APT C",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651014279",
            "telephone_number": "573-680-5586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2707 W EDGEWOOD DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095888",
            "telephone_number": "573-680-5586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEBERG",
        "first_name": "MAGGIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-27",
        "last_updated": "2026-08-27",
        "certification_date": "2026-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "2026041118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.