Individual provider Active NPI

John B Whitaker, M.D.

  • Diagnostic Radiology Physician
  • Lakewood, CO
National Provider Identifier
1013986249
Registry record updated Dec 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2006-0257 Issued in NM
Practice address
12687 W Cedar Dr Ste 200
Lakewood, CO 80228-2014
Phone
(303) 468-1395
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2006-0257 NM Primary
Diagnostic Radiology Physician 2085R0202X 27343 CO
Vascular & Interventional Radiology Physician 2085R0204X 2006-0257 NM

Addresses

Primary practice location

12687 W Cedar Dr Ste 200
Lakewood, CO 80228-2014

Mailing address

12687 W Cedar Dr
Suite 200
Lakewood, CO 80228-2010
Phone (303) 468-1395

Other practice location 1

2490 W 26th Ave
Suite 220
Denver, CO 80211-5314
Phone (303) 433-9729

Other practice location 2

7229 S Flanders St
Centennial, CO 80016-2119
Phone (303) 887-5760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20210611002214 ID Practitioner - Diagnostic Radiology 8729069885 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2006-0257NMMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Vannvei LLC CurrentSince Mar 9, 2021 Accepting new patients
Vannvei LLC CurrentSince Mar 9, 2021 Accepting new patients
Colorado Imaging Associates P C Diagnostic Radiology Past Accepting new patients
New Schryver LLC Past Accepting new patients
Denver NMR, Inc Past Accepting new patients
Twin Cities Radiology, Inc Diagnostic Radiology Past Accepting new patients
Schryver Medical Sales and Marketing Inc. Past Accepting new patients
Taos Mountain Radiology Inc Diagnostic Radiology Past Accepting new patients
Mrigp Inc Past Accepting new patients

Locations

1522 17th St
Lewiston, ID 83501
Phone (208) 743-8416

2841 Juniper Dr
#2
Lewiston, ID 83501
Phone (208) 848-9001

1221 Highland Ave
Clarkston, WA 99403
Phone (509) 751-0312

Organizations & group practices 9

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": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576800000000",
    "number": "1013986249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12687 W CEDAR DR",
            "address_2": "SUITE 200",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802282010",
            "telephone_number": "303-468-1395",
            "fax_number": "303-468-1294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12687 W CEDAR DR STE 200",
            "city": "LAKEWOOD",
            "state": "CO",
            "postal_code": "802282014",
            "telephone_number": "303-468-1395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2490 W 26th Ave",
            "address_2": "Suite 220",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802115314",
            "country_code": "US",
            "telephone_number": "303-433-9729",
            "fax_number": "303-480-0405",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7229 S Flanders St",
            "address_purpose": "LOCATION",
            "city": "Centennial",
            "state": "CO",
            "postal_code": "800162119",
            "country_code": "US",
            "telephone_number": "303-887-5760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "JOHN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2019-12-20",
        "certification_date": "2019-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NM",
            "license": "2006-0257",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CO",
            "license": "27343",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NM",
            "license": "2006-0257",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, CO

Sources for this page

Verify at the official NPI Registry.