Individual provider Active NPI

James Whisner

  • Clinical Social Worker
  • Fredericktown, PA
National Provider Identifier
1073062485
Registry record updated Jan 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW022348 Issued in PA
Practice address
1070 Old National Pike
Fredericktown, PA 15333-2114
Phone
(724) 632-6801
Fax
(724) 632-6312
NPI assigned
Sep 27, 2016
Last updated
Jan 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW022348 PA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1070 Old National Pike
Fredericktown, PA 15333-2114

Mailing address

1070 Old National Pike
Fredericktown, PA 15333-2114
Phone (724) 632-6801

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220105002236 PA Practitioner - Clinical Social Worker 1254722036 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centerville Clinics, Inc.Group PAC ID 7214837202, shared by 24 NPIs, 44 clinicians

Practice addresses (Care Compare)

1070 Old National Pike
Fredericktown, PA 15333-2114
Phone (724) 632-6801

1070 Old National Pike Rd
Fredericktown, PA 15333-2114
Phone (724) 632-6801

37 Highland Ave
Washington, PA 15301-4062
Phone (724) 223-1067

470 Streets Run Rd
Suite 201
Pittsburgh, PA 15236-2023
Phone (724) 802-5132

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Whisners Agds Services Clinical CurrentSince Jan 29, 2025 Accepting new patients

Locations

470 Streets Run Rd
Ste 201
Pittsburgh, PA 15236
Phone (412) 881-8708

Interoperability endpoints

  • Direct secure messaging: james.whisner.1@33484.direct.athenahealth.com

Organizations & group practices 1

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": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641686400000",
    "number": "1073062485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 OLD NATIONAL PIKE",
            "city": "FREDERICKTOWN",
            "state": "PA",
            "postal_code": "153332114",
            "telephone_number": "724-632-6801",
            "fax_number": "724-632-6312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 OLD NATIONAL PIKE",
            "city": "FREDERICKTOWN",
            "state": "PA",
            "postal_code": "153332114",
            "telephone_number": "724-632-6801",
            "fax_number": "724-632-6312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHISNER",
        "first_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-27",
        "last_updated": "2022-01-09",
        "certification_date": "2022-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW022348",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericktown, PA

Sources for this page

Verify at the official NPI Registry.