JAMES WIEBERG (NPI# 1689614596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689614596 |
| Entity Type | Individual |
| Full Name | JAMES WIEBERG |
| Credential | LPC |
| Practice Address |
1432 Southwest Blvd Jefferson City MO 65109 |
| Mailing Address |
1432 Southwest Blvd Capital Region Psychology & Counseling Jefferson City MO 65109 |
| Practice Telephone | 5736325560 |
| Practice Fax Number | 5736325875 |
| Mailing Telephone | 5736325560 |
| Mailing Fax Number | 5736325875 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2009-07-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
612 | MO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 493618003 | 05 | |
| MO | BCBS | 109949 | 01 |
| Street Address |
1432 SOUTHWEST BLVD |
| City | JEFFERSON CITY |
| State | MO |
| Zip Code | 65109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639166481 | Shelby D Rifkin | Internal Medicine | 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 2005-10-05 |
| 1942816897 | Ashley Nicole Bramer | Speech-Language Pathologist | 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 2020-09-16 |
| 1891319877 | Derek Scott Parker | Physical Therapist | 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 2020-06-04 |
| 1205489630 | Jamie Lynn Wilson | Social Worker | 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 2019-07-24 |
| 1902459910 | Miranda L Backes | Counselor | 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 2019-07-18 |
| 1356809297 | Stacy Lynn Stegeman | Counselor | 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 2019-03-11 |
| 1295207371 | Mary Blochberger | Specialist/Technologist | 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 2018-12-29 |
| 1053714154 | Wesley Clifford Thompson | Psychologist | 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 2014-10-02 |
| 1235473380 | Nicole Danielle Borrenpohl | Nurse Practitioner | 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 2012-11-15 |
| 1679825244 | Capital Region Medical Center | Radiology | 1432 Southwest Blvd, Jefferson City, MO 65109-2444 | 2012-10-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518449321 | Kara D Roderick | Physical Therapist | 1115 Fairgrounds Road, Jefferson City, MO 65109 | 2018-08-29 |
| 1851871214 | Integrative Medicine, LLC | Internal Medicine | 999 Diamond Rdg Ste 201, Jefferson City, MO 65109 | 2018-08-15 |
| 1972020394 | Rehab Care Group East, LLC | Clinic/Center | Primrose Retirement Community Jefferson City, 1214 Freedom Boulevard, Jefferson City, MO 65109 | 2017-08-25 |
| 1124558986 | Nicholas Rehagen | Specialist/Technologist | 304 Timber Creek Rd, Jefferson City, MO 65109 | 2017-06-14 |
| 1982004214 | Kara Elizabeth Wilbers | Occupational Therapist | 1105 Fairgrounds Rd, Jefferson City, MO 65109 | 2014-08-22 |
| 1942510334 | Loftin Eyecare, LLC | Optometrist | 724 West Stadium Boulevard, # 029 Walmart Vision Center, Jefferson City, MO 65109 | 2010-10-19 |
| 1306077250 | Paula Hancock Johnson | Social Worker | 1303 Edgewood Dr Ste 5, Jefferson City, MO 65109 | 2009-07-27 |
| 1679701296 | Capital Region Medical Center | Family Medicine | 3308 W Edgewood, Suite B, Jefferson City, MO 65109 | 2009-06-23 |
| 1972730141 | Nancy S Stork | Counselor | 204 Metro, Suite B, Jefferson City, MO 65109 | 2009-06-16 |
| 1356522916 | Walk Easy LLC | Durable Medical Equipment & Medical Supplies | 4810 Rainbow Dr., Jefferson City, MO 65109 | 2007-11-23 |
| Find all providers in zip 65109 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093170219 | Marissa R Abbott | Counselor | 919 Wildwood Dr, Suite 104, Jefferson City, MO 65109-5798 | 2015-12-15 |
| 1043647605 | Gail R Black | Counselor | 2202 Marilyn Dr, Jefferson City, MO 65109-0929 | 2013-09-27 |
| 1649617556 | Carl Adams Adams | Counselor | 1803 Sun Valley Dr, Suite B, Jefferson City, MO 65109-2178 | 2013-05-31 |
| 1891048799 | James Marion Smith | Counselor | 936 Sardonyx Dr, Jefferson City, MO 65109-6852 | 2012-10-17 |
| 1154602266 | Roger Dale Whittler | Counselor | 312 W Dunklin St, Jefferson City, MO 65101-1617 | 2011-09-01 |
| 1851679823 | Alexa Lynn Thompson | Counselor | 1409 Rehagen Blvd, Jefferson City, MO 65101-3736 | 2011-07-25 |
| 1275821860 | Sandra Mcdonald | Counselor | 1110 Missouri Blvd, Jefferson City, MO 65109-1722 | 2011-07-15 |
| 1053569004 | Maria C. Stokes | Counselor | 1110 Peyton Dr, Jefferson City, MO 65101-3769 | 2008-09-03 |
| 1881894392 | Donna Marie Adams | Counselor | 1026 Northeast Dr Ste B, Jefferson City, MO 65109-2517 | 2007-07-23 |
| 1356471734 | Elizabeth L Strolberg Page | Counselor | 415 E Mccarty St, Jefferson City, MO 65101 | 2007-03-06 |
| Find all providers in JEFFERSON CITY | ||||
| City | JEFFERSON CITY |
| Zip Code | 65109 |
Please comment or provide details below to improve the information on JAMES WIEBERG.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.