Provider Demographics
NPI:1992798268
Name:WHEELER, BERNADETTE C (OTR)
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:C
Last Name:WHEELER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:BERNADETTE
Other - Middle Name:C
Other - Last Name:KOENIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12000 W 110TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66210-3938
Mailing Address - Country:US
Mailing Address - Phone:913-491-9404
Mailing Address - Fax:913-754-0365
Practice Address - Street 1:12000 W 110TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-3938
Practice Address - Country:US
Practice Address - Phone:913-491-9404
Practice Address - Fax:913-754-0365
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO000627225X00000X
KS17-00488225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q21513Medicare UPIN