Kevin Michael Whisman, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2000175013 Issued in MO

Practice address

1027 S Main St
Suite 308
Joplin, MO 64801-4527

Phone

(417) 385-3491

Fax

(417) 429-2340

NPI assigned

Sep 26, 2006

Last updated

Apr 25, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mindy Miller LLC

  • Clinical Social Worker
  • Joplin, MO
  • NPI 1699947820
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335312000000",
    "number": "1487755187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1027 S MAIN ST",
            "address_2": "SUITE 308",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648014527",
            "telephone_number": "417-385-3491",
            "fax_number": "417-429-2340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1027 S MAIN ST",
            "address_2": "SUITE 308",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648014527",
            "telephone_number": "417-385-3491",
            "fax_number": "417-429-2340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHISMAN",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2012-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2000175013",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200078010A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495184715",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassey R West
• Shelby Rose West, PA-C
• Laura L Westley
• Danica Rae Westmoreland, DC
• Fredric R Wheeler, D.O.
• Whispering Pines Senior Living L.L.C.
• Adam J White, PA
• Madison Sue White, OD
• Miranda White, SLP
• Samantha White, PLPC

• Psychologist in Joplin, MO
• Providers in Joplin, MO by specialty
• Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.