Active NPI
Sarah Wibbenmeyer
- Behavior Analyst
- Olney, IL
National Provider Identifier
1407286651
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1-19-36840
- Practice address
- 360 Summit St
Olney, IL 62450-2028 - Phone
- (618) 838-5970
- NPI assigned
- Nov 24, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Developmental Therapist | 222Q00000X | |||
| Behavior Analyst | 103K00000X | 1-19-36840 | Primary |
Addresses
Primary practice location
360 Summit St
Olney, IL 62450-2028
Mailing address
716 N Walnut St
Olney, IL 62450-2044
Phone (618) 838-5970
Other practice location 1
716 N Walnut St
Olney, IL 62450-2044
Phone (618) 838-5970
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1385251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1562112000000",
"number": "1407286651",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "716 N WALNUT ST",
"city": "OLNEY",
"state": "IL",
"postal_code": "624502044",
"telephone_number": "618-838-5970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 SUMMIT ST",
"city": "OLNEY",
"state": "IL",
"postal_code": "624502028",
"telephone_number": "618-838-5970"
}
],
"practiceLocations": [
{
"address_1": "716 N Walnut St",
"address_purpose": "LOCATION",
"city": "Olney",
"state": "IL",
"postal_code": "624502044",
"country_code": "US",
"telephone_number": "618-838-5970",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WIBBENMEYER",
"first_name": "SARAH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-24",
"last_updated": "2019-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "103K00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Behavior Analyst",
"state": null,
"license": "1-19-36840",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olney, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.