Individual provider Active NPI

Peter Nicholas Whitehurst, MD

  • Student in an Organized Health Care Education/Training Program
  • Winston Salem, NC
National Provider Identifier
1023802196
Registry record updated Jun 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1200 N Martin Luther King Jr Dr
Winston Salem, NC 27101-3006
Phone
(336) 713-9800
NPI assigned
Apr 5, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1200 N Martin Luther King Jr Dr
Winston Salem, NC 27101-3006

Mailing address

311 Kirk LN
Dothan, AL 36305-7306
Phone (334) 648-4597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20250817000163 NC Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 8921507997

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1743811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750032000000",
    "number": "1023802196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 KIRK LN",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363057306",
            "telephone_number": "334-648-4597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N MARTIN LUTHER KING JR DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271013006",
            "telephone_number": "336-713-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHURST",
        "first_name": "PETER",
        "middle_name": "NICHOLAS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-05",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.