Jeffrey Adam Wilken, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

3571 Issued in MD

Practice address

3020 Hamaker CT
Suite 103
Fairfax, VA 22031-2238

Phone

(703) 876-0966

Fax

(703) 876-1628

NPI assigned

Aug 24, 2006

Sex

Male

Sole proprietor

Yes

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

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Neuropsychology Associates of Fairfax Virginia LLCGroup PAC ID 5597171611, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Neuropsychology Associates of Fairfax Virginia LLC

  • Clinical Neuropsychologist
  • Fairfax, VA
  • NPI 1679177224

  DC

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278979200000",
    "number": "1932216280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 HAMAKER CT",
            "address_2": "SUITE 103",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312238",
            "telephone_number": "703-876-0966",
            "fax_number": "703-876-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 HAMAKER CT",
            "address_2": "SUITE 103",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220312238",
            "telephone_number": "703-876-0966",
            "fax_number": "703-876-1628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKEN",
        "first_name": "JEFFREY",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2010-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MD",
            "license": "3571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Michael Wilder, DO, MPH
• Jack Wilder
• Joseph P Wiley, CSAC
• Rhonda Wiley, LPC. LSATP
• Yudy Emilce Wiley, LPC, CSAC
• Megan Sarah Wilkerson, LCSW
• Lekeithia Wilkes
• Susan D Wilkinson, MSPT
• Kathrin Stephanie Yoshiko Wilkowski, MD, MS
• Julie Ann Will

• Clinical Neuropsychologist in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Clinical Neuropsychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.

Verify at the official NPI Registry.