Individual provider Active NPI

Pattye Whisman, MD

  • Family Medicine Physician
  • Newark, OH
National Provider Identifier
1114925070
Registry record updated Feb 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35-038652 Issued in OH
Practice address
150 McMillen Dr
Newark, OH 43055-1811
Phone
(220) 564-4827
Fax
(220) 564-1894
NPI assigned
Jul 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35-038652 OH Primary

Addresses

Primary practice location

150 McMillen Dr
Newark, OH 43055-1811

Mailing address

150 McMillen Dr
Newark, OH 43055-1811
Phone (220) 564-4827

Other identifiers 1

IdentifierTypeStateIssuer
0332349MedicaidOH

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35-038652OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Licking Memorial Professional Corp. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487548800000",
    "number": "1114925070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 MCMILLEN DR",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551811",
            "telephone_number": "220-564-4827",
            "fax_number": "220-564-1894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 MCMILLEN DR",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430551811",
            "telephone_number": "220-564-4827",
            "fax_number": "220-564-1894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHISMAN",
        "first_name": "PATTYE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-13",
        "last_updated": "2017-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35-038652",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0332349",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2017; 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.