Active NPI
Ladona Rae Wiebler, M.S.
- Behavior Analyst
- Peoria, IL
National Provider Identifier
1912286808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- License
- 1052473
- Practice address
- 507 E Armstrong Ave
Peoria, IL 61603-3201 - Phone
- (309) 686-1177
- Fax
- (309) 686-7722
- NPI assigned
- Aug 9, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | 1052473 | Primary | |
| Speech-Language Pathologist | 235Z00000X | 146001359 | IL |
Addresses
Primary practice location
507 E Armstrong Ave
Peoria, IL 61603-3201
Mailing address
507 E Armstrong Ave
Peoria, IL 61603-3201
Phone (309) 686-1177
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146001359 | IL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312848000000",
"number": "1912286808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "507 E ARMSTRONG AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616033201",
"telephone_number": "309-686-1177",
"fax_number": "309-686-7722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "507 E ARMSTRONG AVE",
"city": "PEORIA",
"state": "IL",
"postal_code": "616033201",
"telephone_number": "309-686-1177",
"fax_number": "309-686-7722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIEBLER",
"first_name": "LADONA",
"middle_name": "RAE",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-09",
"last_updated": "2011-08-09",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": "1052473",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "IL",
"license": "146001359",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Peoria, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.