Individual provider Active NPI

Robert David Whiting, MSW, LCSW

  • Clinical Social Worker
  • Colorado Springs, CO
National Provider Identifier
1124247556
Registry record updated Dec 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW.09926304 Issued in CO
Practice address
6915 Tutt Blvd Ste 110B
Colorado Springs, CO 80923-3591
Phone
(719) 445-1292
Fax
(719) 591-6486
NPI assigned
Apr 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2019

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 CSW.09926304 CO Primary
Clinical Social Worker 1041C0700X 149009582 IL

Addresses

Primary practice location

6915 Tutt Blvd Ste 110B
Colorado Springs, CO 80923-3591

Mailing address

1065 NE 125TH St Ste 409
North Miami, FL 33161-5834
Phone (888) 852-6672

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20200108000778 CO Practitioner - Clinical Social Worker 2860827458 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

2860 S Circle Dr
Suite 109
Colorado Springs, CO 80906-4195
Phone (719) 540-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW.09926304COMDClinical Social Worker
149009582ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC CurrentSince Oct 1, 2021 Accepting new patients
Family Care Center, LLC CurrentSince Jul 11, 2024 Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince Oct 1, 2021 Accepting new patients
Family Care Center, LLC CurrentSince Jul 11, 2024 Accepting new patients

Locations

4404 Barranca Ln
Castle Rock, CO 80104
Phone (720) 733-5260

1400 E Boulder St
Colorado Springs, CO 80909
Phone (719) 365-5120

2860 S Circle Dr
Ste 310
Colorado Springs, CO 80906

1400 E Boulder St
Ste 2508
Colorado Springs, CO 80909
Phone (719) 365-1292

2860 S Circle Dr
Ste 109
Colorado Springs, CO 80906
Phone 71954021004002

Organizations & group practices 4

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": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575504000000",
    "number": "1124247556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 NE 125TH ST STE 409",
            "city": "NORTH MIAMI",
            "state": "FL",
            "postal_code": "331615834",
            "telephone_number": "888-852-6672",
            "fax_number": "305-891-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6915 TUTT BLVD STE 110B",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809233591",
            "telephone_number": "719-445-1292",
            "fax_number": "719-591-6486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITING",
        "first_name": "ROBERT",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2019-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09926304",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149009582",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.