Kristy Lyn Wheeler, BCBA, NCSP

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-10-6812 Issued in IL

Practice address

97 Eastgate Dr
Washington, IL 61571-9271

Phone

(800) 773-1682

NPI assigned

Sep 10, 2013

Last updated

Sep 10, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Skill Sprout, LLC

  • Clinical Social Worker
  • Peoria, IL
  • NPI 1396106647
  NPD (past)

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

{
    "created_epoch": "1378771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378771200000",
    "number": "1821423872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3751 STATE ROUTE 97",
            "city": "PLEASANT PLAINS",
            "state": "IL",
            "postal_code": "626774090",
            "telephone_number": "217-725-4112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "97 EASTGATE DR",
            "city": "WASHINGTON",
            "state": "IL",
            "postal_code": "615719271",
            "telephone_number": "800-773-1682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "KRISTY",
        "middle_name": "LYN",
        "credential": "BCBA, NCSP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-10",
        "last_updated": "2013-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "IL",
            "license": "1-10-6812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Washington Senior Living LLC
• Washington Village Estates, LP (Supportive Living of Washington)
• Washington Volunteer Fire Department and Rescue Squad Inc
• Kelly L Watkins, SPEECH LANG PATH
• Lily Watts
• Theresa A Wiese, LCSW
• Jennifer M Wilson, OD
• Jill Wirth-Rissman, MD
• Wolf Larson Enterprises LLC
• Carrie Marie Woodward, RN

• Behavior Analyst in Washington, IL
• Providers in Washington, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2013; 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.