Individual provider Active NPI

Johnathon Todd Whitehead, DC

  • Chiropractor
  • Amarillo, TX
National Provider Identifier
1063598860
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC6800 Issued in TX
Practice address
5701 W Interstate 40
Amarillo, TX 79106-4619
Phone
(806) 358-3595
Fax
(806) 358-4647
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC6800 TX Primary

Addresses

Primary practice location

5701 W Interstate 40
Amarillo, TX 79106-4619

Mailing address

5701 W Interstate 40
Amarillo, TX 79106-4619
Phone (806) 358-3595

Other identifiers 2

IdentifierTypeStateIssuer
001887101MedicaidTX
8G3166OtherTXBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050112000691 TX Practitioner - Chiropractic 3971552365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Texas Multicare Clinic IncGroup PAC ID 2163470675, 4 clinicians

Practice addresses (Care Compare)

5701 W Interstate 40
Precision Chiropractic
Amarillo, TX 79106-4619
Phone (806) 358-3595

Merit-based Incentive Payment System (MIPS)

Final score
53.82 of 100Reported as individual
Quality
0
Improvement activities
40
Cost
79.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DC6800TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
West Texas Multicare Chiropractor CurrentSince Jul 1, 2001 Accepting new patients
West Texas Multicare Chiropractor Past Accepting new patients
West Texas Multicare Past Accepting new patients

Locations

7 Medical Dr
Amarillo, TX 79106
Phone (806) 355-9355

5701 W Interstate 40
Amarillo, TX 79106
Phone (405) 358-3595

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.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1063598860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5701 W INTERSTATE 40",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791064619",
            "telephone_number": "806-358-3595",
            "fax_number": "806-358-4647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5701 W INTERSTATE 40",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791064619",
            "telephone_number": "806-358-3595",
            "fax_number": "806-358-4647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "JOHNATHON",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "DC6800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001887101",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8G3166",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.