Individual provider Active NPI

Amanda Jun Wible, LSW

  • Counselor
  • Altoona, PA
National Provider Identifier
1487915542
Registry record updated Jun 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
719 N 6TH Ave
Altoona, PA 16601-6003
Phone
(814) 330-6975
NPI assigned
Jun 6, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

719 N 6TH Ave
Altoona, PA 16601-6003

Mailing address

719 N 6TH Ave
Altoona, PA 16601-6003
Phone (814) 330-6975

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170405000843 PA Practitioner - Clinical Social Worker 0749566727 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nulton Diagnostic and Treatment Center, PCGroup PAC ID 5294621363, 38 clinicians

Practice addresses (Care Compare)

214 College Park PLZ
Johnstown, PA 15904-2833
Phone (814) 262-0025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nulton Diagnostic & Treatment Center, PC CurrentSince Jan 1, 2017 Accepting new patients
Nulton Diagnostic & Treatment Center, PC. CurrentSince Jan 1, 2017 Accepting new patients

Locations

214 College Park Plz
Johnstown, PA 15904
Phone (814) 262-0025

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1487915542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 N 6TH AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166016003",
            "telephone_number": "814-330-6975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 N 6TH AVE",
            "city": "ALTOONA",
            "state": "PA",
            "postal_code": "166016003",
            "telephone_number": "814-330-6975"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIBLE",
        "first_name": "AMANDA",
        "middle_name": "JUN",
        "name_prefix": "Mrs.",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Altoona, PA

Sources for this page

Verify at the official NPI Registry.