Clyde Whiting, M.D.

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

036129320 Issued in IL

Practice address

1501 S California Ave
Chicago, IL 60608-1732

Phone

(773) 257-6097

NPI assigned

Jan 4, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, MS, GA3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Attala Emergency Group LLC

  • Emergency Medicine Physician
  • Kosciusko, MS
  • NPI 1407103294
  Medicare reassignment NPD
• Keystone Medical Services of Ms, Inc

  • Emergency Medicine Physician
  • Hazlehurst, MS
  • NPI 1174691059
  Medicare reassignment NPD
• Emanuel County Hospital Authority

  dba Emanuel Surgical Associates

  • Surgery Physician
  • Swainsboro, GA
  • NPI 1003221243
  NPD

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

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1073883203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8336 S HERMITAGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606204629",
            "telephone_number": "312-933-6075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606081732",
            "telephone_number": "773-257-6097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITING",
        "first_name": "CLYDE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-04",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "IL",
            "license": "036129320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benita A Whitfield, MSW
• Cassandra Whitfield, MA, LCSW
• Patrice Whitfield
• Sarah D Whitfield, RN
• Brittina M Whiting, OTR/L
• Dennis C Whiting
• Peter F Whitington, M.D.
• Cy Whitler, PT, DPT
• Ericka Whitley
• Erin Jordan Whitley, PA-C

• Sports Medicine (Family Medicine) Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Sports Medicine (Family Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.