Individual provider Active NPI

Jeffrey Alston Whitener, D.O.

  • Emergency Medicine Physician
  • Bay Minette, AL
National Provider Identifier
1003169392
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
1630 Issued in AL
Practice address
1815 Hand Ave
Bay Minette, AL 36507-4110
Phone
(251) 435-1330
NPI assigned
Oct 24, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X 1630 AL Primary

Addresses

Primary practice location

1815 Hand Ave
Bay Minette, AL 36507-4110

Mailing address

22 Rickarby PL
Mobile, AL 36606-1433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160713001678 AL Practitioner - Emergency Medicine 1759673627 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care 59 PCGroup PAC ID 6002274925, 8 clinicians
Baldwin Emergency Physicians, P.C..Group PAC ID 4688627946, 52 clinicians

Practice addresses (Care Compare)

108 C McMeans Ave
Bay Minette, AL 36507-3130
Phone (251) 491-0059

5 Mobile Infirmary Cir
Mobile, AL 36607-3513
Phone (251) 435-2400

750 Morphy Ave
Fairhope, AL 36532-1812
Phone (251) 928-2375

Hospital & facility affiliations

  • Mobile Infirmary Medical Center Hospital, Mobile, AL, CCN 010113
  • Thomas Hospital Hospital, Fairhope, AL, CCN 010100
  • North Baldwin Infirmary Hospital, Bay Minette, AL, CCN 010129

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
1630ALMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care 59, PC Single Specialty CurrentSince Feb 22, 2023 Accepting new patients
Imc-Emergency Physicians LLC Single Specialty CurrentSince Jan 1, 2019 Accepting new patients
Baldwin Emergency Physicians, P.C.. Single Specialty CurrentSince Dec 1, 2018 Accepting new patients

Locations

108 McMeans Ave
#C
Bay Minette, AL 36507

1815 Hand Ave
Bay Minette, AL 36507
Phone (251) 279-1553

108C McMeans Ave
Bay Minette, AL 36507
Phone (251) 491-0059

750 Morphy Ave
Fairhope, AL 36532
Phone (251) 928-2375

1725 Spring Hill Ave
Mobile, AL 36604
Phone (251) 435-1366

5 Mobile Infirmary Cir
Mobile, AL 36607
Phone (251) 432-4415

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGCFDD/Endpoint/BGCFDD

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Urgent Care 59 PCBay Minette, AL, CCN 018983 Rural health clinic 5% Or Greater Direct Ownership Interest (20%)
Corporate Director
W-2 Managing Employee
Feb 22, 2023
Feb 22, 2023
Feb 22, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1351036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1003169392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 RICKARBY PL",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366061433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 HAND AVE",
            "city": "BAY MINETTE",
            "state": "AL",
            "postal_code": "365074110",
            "telephone_number": "251-435-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITENER",
        "first_name": "JEFFREY",
        "middle_name": "ALSTON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-10-24",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "AL",
            "license": "1630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Minette, AL

Sources for this page

Verify at the official NPI Registry.