Individual provider Active NPI

Andrea Marie Wimmers

  • Behavior Technician
  • Ridgefield, CT
National Provider Identifier
1508617457
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior TechnicianTaxonomy code 106S00000X
Practice address
35 Copps Hill Rd Ste 6
Ridgefield, CT 06877-4041
Phone
(203) 978-3177
NPI assigned
Mar 28, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Technician 106S00000X CT Primary

Addresses

Primary practice location

35 Copps Hill Rd Ste 6
Ridgefield, CT 06877-4041

Mailing address

35 Copps Hill Rd Ste 6
Ridgefield, CT 06877-4041
Phone (203) 978-3177

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": "1711584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711584000000",
    "number": "1508617457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 COPPS HILL RD STE 6",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068774041",
            "telephone_number": "203-978-3177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 COPPS HILL RD STE 6",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068774041",
            "telephone_number": "203-978-3177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIMMERS",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.