Kevin J Wheatley, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

23819 Issued in TN

Practice address

294 Summar Dr
Jackson, TN 38301-3915

Phone

(731) 423-1932

Fax

(731) 410-0367

NPI assigned

Jul 17, 2006

Last updated

Jan 27, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University of Tennessee

  • Family Medicine Physician
  • Jackson, TN
  • NPI 1780686436
  NPD
• Jackson Clinic PA

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1285629386

  Family Medicine

  NPD (past)
• Jackson Clinic PA

  dba Jackson Clinc PA DME

  • Durable Medical Equipment & Medical Supplies
  • Jackson, TN
  • NPI 1689443038
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296086400000",
    "number": "1083632251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013915",
            "telephone_number": "731-423-1932",
            "fax_number": "731-410-0367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013915",
            "telephone_number": "731-423-1932",
            "fax_number": "731-410-0367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEATLEY",
        "first_name": "KEVIN",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2011-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "23819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3070786",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00264255",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TLC",
            "identifier": "33916",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4101274",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• West TN Pharmaceutical Care, LLC
• Mark Ellis West, PHARM.D.
• Naadia West, MD
• Adam Westmoreland, MSSW
• Stacey Whalley, MSN, FNP-BC
• Brian E Whitby, PHARMD
• Debra B Whitby, RD
• Stella M White Day, FNP APN
• Amy Watson White, WHNP
• Antonio White

• Family Medicine Physician in Jackson, TN
• Providers in Jackson, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; 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.