NPIMap

Individual provider Active NPI

Clay T Whiddon

  • Medical Physician Assistant
  • Aurora, CO
National Provider Identifier
1043940653
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.0007556 Issued in CO
Practice address
12505 E. 16TH Ave B 215
Aurora, CO 80045-2545
Phone
(720) 848-0000
NPI assigned
Jun 15, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Medical Physician Assistant 363AM0700X PA.0007556 CO Primary

Addresses

Primary practice location

12505 E. 16TH Ave B 215
Aurora, CO 80045-2545

Mailing address

PO Box 110429
Aurora, CO 80042-0429

Other practice location 1

15300 E Missippi Ave
Aurora, CO 80017
Phone (303) 671-4140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221011000884 CO Practitioner - Physician Assistant 5294111571 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

12605 E 16TH Ave
Uchealth Anschutz Medical Campus
Aurora, CO 80045-2545
Phone (720) 848-0000

13123 E 16TH Ave
Aurora, CO 80045-7106
Phone (720) 777-1234

Hospital & facility affiliations

  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Physicians, Incorporated CurrentSince Mar 16, 2025 Accepting new patients

Locations

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

Organizations & group practices 3

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.

Hospital & facility affiliations 27

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 27

NPI Registry JSON

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

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1043940653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 110429",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800420429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12505 E. 16TH AVE B 215",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452545",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15300 E Missippi Ave",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "80017",
            "country_code": "US",
            "telephone_number": "303-671-4140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHIDDON",
        "first_name": "CLAY",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CO",
            "license": "PA.0007556",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aurora, CO

Sources for this page

Verify at the official NPI Registry.