Active NPI
Dale Wilkinson
- Psychologist
- Joplin, MO
National Provider Identifier
1295166619
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 01807
- Practice address
- 530 E 32ND St
Joplin, MO 64804-3904 - Phone
- (417) 347-7500
- NPI assigned
- Dec 11, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 01807 | MO | Primary |
Addresses
Primary practice location
530 E 32ND St
Joplin, MO 64804-3904
Mailing address
PO Box 2526
Joplin, MO 64803-2526
Phone (417) 347-7600
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01807 | MO | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386720000000",
"number": "1295166619",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2526",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648032526",
"telephone_number": "417-347-7600",
"fax_number": "417-347-7608"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 E 32ND ST",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648043904",
"telephone_number": "417-347-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILKINSON",
"first_name": "DALE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-12-11",
"last_updated": "2013-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MO",
"license": "01807",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joplin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.