Individual provider Active NPI

Mary Whittemore, M.D., M.P.H.

  • Family Medicine Physician
  • Charlottesville, VA
National Provider Identifier
1023452562
Registry record updated Aug 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0101260888 Issued in VA
Practice address
540 Belvedere Blvd Ste 100
Charlottesville, VA 22901-3215
Phone
(434) 654-2830
Fax
(833) 232-3632
NPI assigned
Apr 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0101260888 VA Primary

Addresses

Primary practice location

540 Belvedere Blvd Ste 100
Charlottesville, VA 22901-3215

Mailing address

PO Box 79777
Baltimore, MD 21279-0777
Phone (434) 654-7794

Other practice location 1

416 Albemarle Sq
Charlottesville, VA 22901
Phone (434) 654-2830

Other practice location 2

416 Albemarle Sq
Charlottesville, VA 22901-7400
Phone (434) 978-2126

Other practice location 3

416 Albemarle Sq
Charlottesville, VA 22901-7400
Phone (434) 978-2126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20161003002435 VA Practitioner - Family Practice 0143457325 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Martha Jefferson Medical Group LLC Family Medicine CurrentSince Aug 5, 2019 Accepting new patients
Martha Jefferson Hospital PastSince Sep 5, 2023 Accepting new patients

Locations

540 Belvedere Blvd
#100
Charlottesville, VA 22901
Phone (434) 654-2830

416 Albemarle Sq
Charlottesvle, VA 22901
Phone (434) 220-0021

1646 Park Ridge Dr
Crozet, VA 22932
Phone (434) 654-2760

Interoperability endpoints

  • Direct secure messaging: mary.whittemore.1@20955.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1367020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1023452562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 79777",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212790777",
            "telephone_number": "434-654-7794",
            "fax_number": "833-732-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 BELVEDERE BLVD STE 100",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229013215",
            "telephone_number": "434-654-2830",
            "fax_number": "833-232-3632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "416 Albemarle Sq",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "22901",
            "country_code": "US",
            "telephone_number": "434-654-2830",
            "fax_number": "833-732-3632",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "416 Albemarle Sq",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229017400",
            "country_code": "US",
            "telephone_number": "434-978-2126",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "416 Albemarle Sq",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229017400",
            "country_code": "US",
            "telephone_number": "434-978-2126",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITTEMORE",
        "first_name": "MARY",
        "credential": "M.D., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-27",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101260888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.