Individual provider Active NPI

Garrick Mark Whitlock, CRNA

  • Certified Registered Nurse Anesthetist
  • Providence, RI
National Provider Identifier
1023346491
Registry record updated Dec 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RNA36728 Issued in RI
Practice address
825 Chalkstone Ave
Providence, RI 02908-4728
Phone
(401) 456-2000
NPI assigned
Nov 24, 2009
Last updated
Dec 28, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RNA36728 RI Primary
Certified Registered Nurse Anesthetist 367500000X RN2259866 MA

Addresses

Primary practice location

825 Chalkstone Ave
Providence, RI 02908-4728

Mailing address

PO Box 6064
Providence, RI 02904

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130104000297 MA Practitioner - Certified Registered Nurse Anesthetist (Crna) 9234265133 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri Anesthesia LLCGroup PAC ID 2062931215, 38 clinicians

Practice addresses (Care Compare)

300 Grove St
Worcester, MA 01605-3908
Phone (781) 585-9522

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN2259866MAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Prima Care, PC CurrentSince Jun 1, 2021 Accepting new patients
Prima Care, PC CurrentSince Jun 1, 2021 Accepting new patients
Tri Anesthesia LLC CurrentSince Aug 10, 2025 Accepting new patients
Milford Anesthesia Consultants PC CurrentSince Sep 1, 2020 Accepting new patients
Icon Anesthesia Services of New England LLC CurrentSince Jan 20, 2025 Accepting new patients
Atlantic Anesthesia, P.C. CurrentSince Jan 21, 2019 Accepting new patients
Umass Memorial Medical Group Inc CurrentSince Jan 11, 2016 Accepting new patients
JJM Medical Services, PC CurrentSince Mar 1, 2020 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Jan 11, 2016 Accepting new patients
Anesthesia Associates of New London, PC PastSince Dec 9, 2019 Accepting new patients
A&B Anesthesia Associates, PC PastSince Oct 27, 2009 Accepting new patients

Locations

321 Billerica Rd
Chelmsford, MA 01824
Phone (978) 256-3219

277 Pleasant St
Ste 240
Fall River, MA 02721
Phone (500) 300-3271

14 Prospect St
Milford, MA 01757
Phone (508) 422-2343

100 Morse St
Norwood, MA 02062
Phone (781) 255-0362

90 New State Hwy
Raynham, MA 02767
Phone (508) 823-7473

67 Slades Ferry Ave
Somerset, MA 02726
Phone (508) 673-9400

211 Park St
South Attleboro, MA 02703
Phone (508) 222-5200

1440 Main St
Waltham, MA 02451
Phone (781) 891-9300

300 Grove St
Worcester, MA 01605
Phone (508) 754-0700

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

444 Quaker Ln
Warwick, RI 02886
Phone (401) 935-1439

Organizations & group practices 12

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": "1259020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451260800000",
    "number": "1023346491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6064",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084728",
            "telephone_number": "401-456-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLOCK",
        "first_name": "GARRICK",
        "middle_name": "MARK",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-24",
        "last_updated": "2015-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "RI",
            "license": "RNA36728",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MA",
            "license": "RN2259866",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.