Joseph R Whiteley, M.D.

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Practice address

2300 N Rockton Ave
Ste 304
Rockford, IL 61103-3619

Phone

(815) 964-3333

Fax

(815) 964-3331

NPI assigned

Jun 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Affiliated Surgeons of Rockford LLC

  • Surgery Physician
  • Rockford, IL
  • NPI 1851394696
  NPD (past)

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197849600000",
    "number": "1043216112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15730",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611325730",
            "telephone_number": "815-964-3333",
            "fax_number": "815-964-3331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 N ROCKTON AVE",
            "address_2": "STE 304",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611033619",
            "telephone_number": "815-964-3333",
            "fax_number": "815-964-3331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITELEY",
        "first_name": "JOSEPH",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2007-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036071666 2",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL CARE",
            "identifier": "194269",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan White, RN
• Roxanne White, NP-C
• Scott S. White, M.D.
• Shameka Paris White, PA-C
• Jon B Whitehurst, M.D.
• Whitney S Blakely PC
• Alexander Whitney, PA-C
• Gena Whitson, LCPC
• Christine Grace Wholey, MT-BC
• Marilyn Kendrick Wholey, MS,CCC/SLP,L

• Plastic and Reconstructive Surgery Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Plastic and Reconstructive Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.