Jason Wibbenmeyer, D.C.

Key facts

NPI

1891090965

Entity type

Individual (NPI type 1)

Primary specialty

Chiropractor 111N00000X

License

2011000732 (MO)

Practice address

49 N Gore Ave
Webster Groves, MO 63119-2357

Phone

(314) 219-1888

NPI assigned

Jan 20, 2011

Sex

Male

Sole proprietor

No

Organizations & group practices 1

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.

• Alethea Eller, DC PC Chiropractor · Webster Groves, MO · NPI 1457775173
  NPD (past) CHIROPRACTOR

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jun 2, 2014.

{
    "created_epoch": "1295481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401667200000",
    "number": "1891090965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 N GORE AVE",
            "city": "WEBSTER GROVES",
            "state": "MO",
            "postal_code": "631192357",
            "telephone_number": "314-219-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 N GORE AVE",
            "city": "WEBSTER GROVES",
            "state": "MO",
            "postal_code": "631192357",
            "telephone_number": "314-219-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIBBENMEYER",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-20",
        "last_updated": "2014-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2011000732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sharon Whalen, D.C.
• Gina Maria White, RDH
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• Jennifer Marie Wickersham, L.P.C.
• Justin Wilkinson, OD
• Kristan M Wilson, DC
• Tanya Marie Windmiller, DENTAL ASSISTANT
• Karlye Wojton

All providers in Webster Groves, MO · Chiropractor in Missouri