Active NPI
Spencer David Wideman
- Behavior Analyst
- Tulsa, OK
National Provider Identifier
1962036251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 4908 S Sheridan Rd
Tulsa, OK 74145-5712 - Phone
- (918) 984-9153
- NPI assigned
- Feb 26, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
4908 S Sheridan Rd
Tulsa, OK 74145-5712
Mailing address
1523 E 55TH St
Tulsa, OK 74105-6918
Phone (918) 607-1024
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spectrum of Hope, LLC | Behavior Analyst | Past | Accepting new patients |
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582675200000",
"number": "1962036251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1523 E 55TH ST",
"city": "TULSA",
"state": "OK",
"postal_code": "741056918",
"telephone_number": "918-607-1024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4908 S SHERIDAN RD",
"city": "TULSA",
"state": "OK",
"postal_code": "741455712",
"telephone_number": "918-984-9153"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WIDEMAN",
"first_name": "SPENCER",
"middle_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-02-26",
"last_updated": "2020-02-26",
"certification_date": "2020-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.