DR. JOHN DAVID WIMBERLY (NPI# 1518080316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518080316 |
| Entity Type | Individual |
| Full Name | DR. JOHN DAVID WIMBERLY |
| Credential | PH.D. |
| Practice Address |
612 E Main St Suite B Bozeman MT 59715-3719 |
| Practice Telephone | 4065820500 |
| Mailing Telephone | 4065820500 |
| Enumeration Date | 2007-04-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
318 | MT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | BLUE CROSS BLUE SHIELD | 51821 | 01 |
| Street Address |
612 E MAIN ST SUITE B |
| City | BOZEMAN |
| State | MT |
| Zip Code | 59715-3719 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801374400 | Tessa Moeckel | Speech-Language Pathologist | 612 E Main St, Bozeman, MT 59715-3719 | 2018-08-06 |
| 1477094522 | Tia Cheyenne Sutton | Occupational Therapist | 612 E Main St, C, Bozeman, MT 59715-3719 | 2017-03-08 |
| 1104277151 | Carly L Valentine | Occupational Therapist | 612 E Main St, Suite C, Bozeman, MT 59715-3719 | 2016-06-30 |
| 1275900144 | Sara Macpherson | Speech-Language Pathologist | 612 E Main St, Suite C, Bozeman, MT 59715-3719 | 2015-08-27 |
| 1790177251 | Hannah Elizabeth Miller | Occupational Therapist | 612 E Main St, Bozeman, MT 59715-3719 | 2015-02-20 |
| 1497154348 | Jill Juliet Imsand Chumbley | Speech-Language Pathologist | 612 E Main St, #c, Bozeman, MT 59715-3719 | 2014-08-16 |
| 1629205943 | Alysan N Long | Physical Therapist | 612 E Main St, Suite A, Bozeman, MT 59715-3719 | 2009-06-12 |
| 1669682365 | Ann Katherine Cowley | Physical Therapist | 612 E Main St, Suite C, Bozeman, MT 59715-3719 | 2007-05-23 |
| 1982817029 | Holly Lynn Anderson | Occupational Therapy Assistant | 612 E Main St, Suite C, Bozeman, MT 59715-3719 | 2007-05-07 |
| 1194840900 | Peter Strom | Counselor | 612 E Main St, Suite B, Bozeman, MT 59715-3719 | 2007-03-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477152288 | Ch Mh Services (il), LLC | Clinic/Center | 233 E Main St Suite 401, Bozeman, MT 59715 | 2020-10-22 |
| 1134735269 | Montana Therapy and Consulting Pllc | Social Worker | 110 S Grand Ave, Floor 2, Bozeman, MT 59715 | 2020-09-23 |
| 1831715994 | Alyson Raph | Student in an Organized Health Care Education/Training Program | 1 Anna Pearl Sherrick Hal, Bozeman, MT 59715 | 2020-06-24 |
| 1639702780 | Miranda Shields | Massage Therapist | 1001 W. Oak St. Bldg C Ste 210, Bozeman, MT 59715 | 2020-02-18 |
| 1154988590 | Christina Yancy | Massage Therapist | Bldg C, Ste 210, 1001 W Oak St, Bozeman, MT 59715 | 2019-05-21 |
| 1962068767 | Julie A Hisey | Physical Therapist | 1700 W. Koch, Suite 12, Bozeman, MT 59715 | 2019-05-16 |
| 1639631633 | Joshua Wallace | Massage Therapist | 1001 W Oak St, Bldg. C Ste. 210, Bozeman, MT 59715 | 2019-04-01 |
| 1528523388 | Judith Margaret Firehammer | Psychologist | 37 East Main St, Suite 7, Bozeman, MT 59715 | 2019-02-06 |
| 1194280875 | Erica Kotick | Counselor | 2246 Boot Hill Court, Suite 4, Bozeman, MT 59715 | 2019-02-06 |
| 1194291609 | Providence Mental Health Pllc | Social Worker | 2246 Boot Hill Ct. Unit #4, Bozeman, MT 59715 | 2018-10-23 |
| Find all providers in zip 59715 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528523388 | Judith Margaret Firehammer | Psychologist | 37 East Main St, Suite 7, Bozeman, MT 59715 | 2019-02-06 |
| 1700390085 | Hillary Kaitlin Morin | Psychologist | 5 W Mendenhall St Ste 202, Bozeman, MT 59715-3559 | 2017-11-26 |
| 1407214968 | Kathryn Darnell | Psychologist | 502 S 19th Ave Ste 300, Bozeman, MT 59718-6810 | 2016-01-29 |
| 1891116117 | Leightnup Psychology Services PC | Psychologist | 935 Highland Blvd Suite 2200, Bozeman, MT 59715-6902 | 2014-01-05 |
| 1265875124 | Samantha Nicole White | Psychologist | 211 Swingle Building, Montana State University, Bozeman, MT 59717-3180 | 2013-04-10 |
| 1770884512 | Eduardo F Duran | Psychologist | 37 E Main St Ste 7, Bozeman, MT 59715-4739 | 2010-11-10 |
| 1396912655 | Candice Marie Tate | Psychologist | 510 S 23rd Ave, Bozeman, MT 59718-3963 | 2008-05-14 |
| 1194902726 | Adrian B Utsch | Psychologist | 300 N Willson Ave Ste 3005-6, Bozeman, MT 59715-3537 | 2008-01-25 |
| 1053503169 | Catherine Anne Maclean | Psychologist | 3825 Valley Commons Dr, Ste 4, Bozeman, MT 59718-6435 | 2007-08-13 |
| 1407997471 | Jacqueline H Stanley | Psychologist | 1043 Stoneridge Dr Ste 2, Bozeman, MT 59718-7084 | 2007-02-10 |
| Find all providers in BOZEMAN | ||||
Please comment or provide details below to improve the information on DR. JOHN DAVID WIMBERLY.
| 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.