Individual provider Active NPI

Ann Hazen Whisenant, PA-C

  • Surgical Physician Assistant
  • San Leandro, CA
National Provider Identifier
1063486264
Registry record updated Aug 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
11627 Issued in CA
Practice address
2500 Merced St
San Leandro, CA 94577-4201
Phone
(510) 454-1000
Fax
(925) 215-2251
NPI assigned
Feb 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 11627 CA Primary

Addresses

Primary practice location

2500 Merced St
San Leandro, CA 94577-4201

Mailing address

2500 Merced St
San Leandro, CA 94577-4201
Phone (510) 454-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11627CAMDChiropractor
PA11827CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Neil D. Rudo, M.D., a Professional Corporation Past Accepting new patients
Surgical Physician Assistants, Inc. Surgical PastSince Apr 30, 2003 Accepting new patients
Jack H. Stehr, M.D., Professional Corporation Past Accepting new patients
Bass Medical Group Past Accepting new patients
Cypress Coast Cardiac Surgeons Medical Group Inc Past Accepting new patients
Robert W. Fowler, M.D. a Professional Corporation Past Accepting new patients
Innovative Wellness Inc a Nursing Corporation PastSince Mar 6, 2018 Accepting new patients

Organizations & group practices 7

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438560000000",
    "number": "1063486264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 MERCED ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774201",
            "telephone_number": "510-454-1000",
            "fax_number": "925-215-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 MERCED ST",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945774201",
            "telephone_number": "510-454-1000",
            "fax_number": "925-215-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHISENANT",
        "first_name": "ANN",
        "middle_name": "HAZEN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-14",
        "last_updated": "2015-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CA",
            "license": "11627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2015; 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.