Active NPI
Bonnie L Whipple, PH.D.
- Clinical Psychologist
- Selinsgrove, PA
National Provider Identifier
1609841600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PS-006902L
- Practice address
- 905 US Rte 522
Evangelical Medical Building
Selinsgrove, PA 17870 - Phone
- (570) 374-0496
- Fax
- (570) 374-3295
- NPI assigned
- Feb 22, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PS-006902L | PA | Primary |
Addresses
Primary practice location
905 US Rte 522
Evangelical Medical Building
Selinsgrove, PA 17870
Mailing address
10 Burgess Ave
Selinsgrove, PA 17870-9403
Phone (570) 374-0496
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0018933940003 | Medicaid | PA | |
| 50009445 | Other | PA | CAPITAL BLUE CROSS |
| 001411997 | Other | PA | HIGHMARK BC/BS |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050426001161 | PA | Practitioner - Clinical Psychologist | 2062451339 | Practice locations: Williamsport, PA; Selinsgrove, PA; Port Trevorton, PA; Montoursville, PA |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
935 Route 522
Selinsgrove, PA 17870-9714
Phone (570) 374-0496
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS-006902L | PA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274659200000",
"number": "1609841600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 BURGESS AVE",
"city": "SELINSGROVE",
"state": "PA",
"postal_code": "178709403",
"telephone_number": "570-374-0496"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "905 US RTE 522",
"address_2": "EVANGELICAL MEDICAL BUILDING",
"city": "SELINSGROVE",
"state": "PA",
"postal_code": "17870",
"telephone_number": "570-374-0496",
"fax_number": "570-374-3295"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHIPPLE",
"first_name": "BONNIE",
"middle_name": "L",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-22",
"last_updated": "2010-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "PA",
"license": "PS-006902L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0018933940003",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "50009445",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BC/BS",
"identifier": "001411997",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Selinsgrove, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.