Jovan Marcel Wimberg

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

BH007259 Issued in PA

Practice address

610 York Rd Ste 640
Jenkintown, PA 19046-2837

Phone

(484) 965-9966

Fax

(484) 231-8631

NPI assigned

Aug 21, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jovan Marcel Ihor Derev'Yanko Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Helping Hands Family Pennsylvania LLC

  • Community/Behavioral Health Agency
  • King of Prussia, PA
  • NPI 1225678709

  Behavior Analyst

  NPD (past)

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

{
    "created_epoch": "1724198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1427881994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 FREEDOM BUSINESS CTR DR STE 220",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194061376",
            "telephone_number": "484-965-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 YORK RD STE 640",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190462837",
            "telephone_number": "484-965-9966",
            "fax_number": "484-231-8631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIMBERG",
        "first_name": "JOVAN",
        "middle_name": "MARCEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-21",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "BH007259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOVAN",
            "last_name": "IHOR DEREV'YANKO",
            "middle_name": "MARCEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stashagay Whitfield
• Sharee Wicks
• Ryan Wiggon
• Aleksandra Wilkowski, COTA/L
• Hannah C Williams
• Carolyn M Wise, CMT
• Charles Adam Wisniewski, DMD
• Women's Wellness of Abington
• Won Hee Kim MD
• Twana Wood, SW

• Behavior Analyst in Jenkintown, PA
• Providers in Jenkintown, PA by specialty
• Behavior Analyst in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.