NPIMap

Individual provider Active NPI

David John Whaley, M.D.

  • Geriatric Psychiatry Physician
  • Sioux Falls, SD
National Provider Identifier
1124285499
Registry record updated Oct 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Psychiatry PhysicianTaxonomy code 2084P0805X
License
8439 Issued in SD
Practice address
4400 W. 69TH Street
Suite 1500
Sioux Falls, SD 57108-8171
Phone
(605) 322-5700
Fax
(605) 322-5704
NPI assigned
May 22, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Geriatric Psychiatry Physician 2084P0805X 8439 SD Primary

Addresses

Primary practice location

4400 W. 69TH Street
Suite 1500
Sioux Falls, SD 57108-8171

Mailing address

PO Box 86370
Sioux Falls, SD 57118-6370
Phone (605) 322-7510

Other identifiers 1

IdentifierTypeStateIssuer
7103020MedicaidSD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121119000527 SD Practitioner - Psychiatry 8022269190

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Sanford School of Medicine of University of South Dakota, 2008
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4400 W 69TH St
Suite 1500
Sioux Falls, SD 57108-8171

Hospital & facility affiliations

  • Avera McKennan Hospital & University Health Center Hospital, Sioux Falls, SD, CCN 430016
  • Sanford Usd Medical Center Hospital, Sioux Falls, SD, CCN 430027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Aug 25, 2012 Accepting new patients
Avera McKennan CurrentSince Aug 25, 2012 Accepting new patients
Avera McKennan Current Accepting new patients
Avera McKennan Past Accepting new patients
Avera McKennan Past Accepting new patients

Locations

4400 W 69th St
Ste 1500
Sioux Falls, SD 57108
Phone (605) 322-5700

Interoperability endpoints

  • Direct secure messaging: david.whaley@avera.sdhealthlink.net

Organizations & group practices 5

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.

Hospital & facility affiliations 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539216000000",
    "number": "1124285499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86370",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571186370",
            "telephone_number": "605-322-7510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 W. 69TH STREET",
            "address_2": "SUITE 1500",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571088171",
            "telephone_number": "605-322-5700",
            "fax_number": "605-322-5704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALEY",
        "first_name": "DAVID",
        "middle_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-22",
        "last_updated": "2018-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0805X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Geriatric Psychiatry",
            "state": "SD",
            "license": "8439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7103020",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.