Individual provider Active NPI

Jan Leigh Wheeler, PHD

  • Psychologist
  • Columbia, MO
National Provider Identifier
1952492639
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
2003023873 Issued in MO
Practice address
2804 Forum Blvd
Suite 4
Columbia, MO 65203
Phone
(573) 446-5034
Fax
(573) 446-5046
NPI assigned
Sep 27, 2006
Last updated
Nov 28, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 2003023873 MO Primary

Addresses

Primary practice location

2804 Forum Blvd
Suite 4
Columbia, MO 65203

Mailing address

2804 Forum Blvd
Suite 4
Columbia, MO 65203
Phone (573) 446-5034

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2003023873MOMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
The Counseling Hub LLC CurrentSince Oct 30, 2024 Accepting new patients
Success Health System, LLC PastSince Dec 1, 2022 Accepting new patients

Locations

2804 Forum Blvd
Ste 4
Columbia, MO 65203
Phone (573) 446-5034

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196208000000",
    "number": "1952492639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 FORUM BLVD",
            "address_2": "SUITE 4",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "65203",
            "telephone_number": "573-446-5034",
            "fax_number": "573-446-5046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 FORUM BLVD",
            "address_2": "SUITE 4",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "65203",
            "telephone_number": "573-446-5034",
            "fax_number": "573-446-5046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "JAN",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MO",
            "license": "2003023873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2007; 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.