Individual provider Active NPI

Anne K Whitis, P.T.

  • Physical Therapist
  • Chinle, AZ
National Provider Identifier
1023008877
Registry record updated Jan 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1449 Issued in AK
Practice address
Highway 191 and Hospital Road
Chinle Comprehensive Health Care Facility
Chinle, AZ 86503
Phone
(928) 674-7166
Fax
(928) 674-7705
NPI assigned
Oct 24, 2005
Last updated
Jan 14, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1449 AK Primary

Addresses

Primary practice location

Highway 191 and Hospital Road
Chinle Comprehensive Health Care Facility
Chinle, AZ 86503

Mailing address

P.O. Drawer PH
Chinle Comprehensive Health Care Facility
Chinle, AZ 86503-8000
Phone (928) 674-7166

Other identifiers 1

IdentifierTypeStateIssuer
PT3778MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100304000222 TX Practitioner - Physical Therapist in Private Practice 2668517434 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1449AKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS PHS Naihs Chinle Comprehensive Health Care Facility CurrentSince Jan 8, 2013 Accepting new patients
DHHS PHS Naihs Chinle Comprehensive CurrentSince Jan 8, 2013 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358121600000",
    "number": "1023008877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. DRAWER PH",
            "address_2": "CHINLE COMPREHENSIVE HEALTH CARE FACILITY",
            "city": "CHINLE",
            "state": "AZ",
            "postal_code": "865038000",
            "telephone_number": "928-674-7166",
            "fax_number": "928-674-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HIGHWAY 191 AND HOSPITAL ROAD",
            "address_2": "CHINLE COMPREHENSIVE HEALTH CARE FACILITY",
            "city": "CHINLE",
            "state": "AZ",
            "postal_code": "86503",
            "telephone_number": "928-674-7166",
            "fax_number": "928-674-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITIS",
        "first_name": "ANNE",
        "middle_name": "K",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-24",
        "last_updated": "2013-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "1449",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT3778",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chinle, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.