Active NPI
Michael Neil Wimberley
- Social Worker
- Albany, NY
National Provider Identifier
1679970792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 121002
- Practice address
- 401 New Karner Rd
Albany, NY 12205-3854 - Phone
- (518) 292-5451
- NPI assigned
- Dec 4, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 121002 | NY | Primary |
| Case Manager/Care Coordinator | 171M00000X |
Addresses
Primary practice location
401 New Karner Rd
Albany, NY 12205-3854
Mailing address
401 New Karner Rd
Albany, NY 12205-3854
Phone (518) 292-5451
Other practice location 1
612 Woodland Square Loop SE Ste 401
Lacey, WA 98503-1070
Phone (360) 763-5828
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 121002 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Parsons Child and Family Center | Past | Accepting new patients | |
| Thurston Mason Behavioral Health Organization | Past | Accepting new patients | |
| Olympic Health and Recovery Services | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Custodial Care Facility
- Albany, NY
- NPI 1922171305
-
- Community/Behavioral Health Agency
- Lacey, WA
- NPI 1760007504
-
- Community/Behavioral Health Agency
- Lacey, WA
- NPI 1265932198
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417651200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695600000000",
"number": "1679970792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "401 NEW KARNER RD",
"city": "ALBANY",
"state": "NY",
"postal_code": "122053854",
"telephone_number": "518-292-5451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 NEW KARNER RD",
"city": "ALBANY",
"state": "NY",
"postal_code": "122053854",
"telephone_number": "518-292-5451"
}
],
"practiceLocations": [
{
"address_1": "612 Woodland Square Loop SE Ste 401",
"address_purpose": "LOCATION",
"city": "Lacey",
"state": "WA",
"postal_code": "985031070",
"country_code": "US",
"telephone_number": "360-763-5828",
"fax_number": "360-489-1435",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WIMBERLEY",
"first_name": "MICHAEL",
"middle_name": "NEIL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-04",
"last_updated": "2023-09-25",
"certification_date": "2023-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "121002",
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.