Brandon Lane Whitlock, AG-ACNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61081911 Issued in WA

Practice address

1119 Highland Ave Ste 7
Clarkston, WA 99403-2836

Phone

(509) 758-1119

NPI assigned

Oct 15, 2009

Last updated

May 29, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in ID, WA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tri-State Memorial HospitalGroup PAC ID 4082502422, 33 clinicians

St Joseph Hospital LLCGroup PAC ID 8325325806, shared by 6 NPIs, 91 clinicians

Meza Post Acute and Long Term Care PLLCGroup PAC ID 4981028503, 26 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ahc Home Health of Coeur D Alene LLC Home health agency, Coeur D'Alene, ID, CCN 137130
• Elite Home Health Home health agency, Clarkston, WA, CCN 507111
• Tri-State Memorial Hospital Hospital, Clarkston, WA, CCN 501332
• St Joseph Regional Medical Center Hospital, Lewiston, ID, CCN 130003

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

• Tri-State Memorial Hospital

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1598814352

  ID

  Medicare reassignment Care Compare group NPD
• Meza Post Acute and Long Term Care, PLLC

  • Geriatric Medicine (Family Medicine) Physician
  • Coeur d'Alene, ID
  • NPI 1932725215

  WA

  Medicare reassignment Care Compare group NPD
• St Joseph Hospital LLC

  • Internal Medicine Physician
  • Lewiston, ID
  • NPI 1043744287

  WA

  Medicare reassignment NPD
• St Joseph Hospital LLC

  • Internal Medicine Physician
  • Lewiston, ID
  • NPI 1205368404
  Medicare reassignment NPD
• Vannvei LLC

  • Multi-Specialty Clinic/Center
  • Lewiston, ID
  • NPI 1881200517
  Medicare reassignment NPD
• Tri-State Memorial Hospital

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1760485221
  Medicare reassignment
• Tri-State Memorial Hospital

  • Community Based Hospice Care Agency
  • Clarkston, WA
  • NPI 1831100254
  NPD
• Vannvei LLC

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Clarkston, WA
  • NPI 1124186804
  NPD
• Tri-State Memorial Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Lewiston, ID
  • NPI 1386690907
  NPD
• Martin Family Medicine LLC

  • Family Medicine Physician
  • Clarkston, WA
  • NPI 1710118542
  NPD (past)
• Snake River Adult Medicine LLC

  • Primary Care Clinic/Center
  • Clarkston, WA
  • NPI 1548752918
  NPD (past)

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

• Alpowa Healthcare, Inc.

  dba Elite Home Health and Hospice

  • Home Health Agency
  • Clarkston, WA
  • NPI 1255672895
  Care Compare affiliation
• Tri-State Memorial Hospital

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1760485221
  Care Compare affiliation
• Tri-State Memorial Hospital

  dba Tri State Medical Clinics

  • Family Medicine Physician
  • Clarkston, WA
  • NPI 1932405693

  Hospital

  Care Compare affiliation
• Ahc Home Health of Coeur D Alene LLC

  dba Advanced Home Care & Hospice of Northern Idaho

  • Home Health Agency
  • Coeur d'Alene, ID
  • NPI 1457802860
  Care Compare affiliation
• St Joseph Hospital LLC

  • Oxygen Equipment & Supplies (DME)
  • Lewiston, ID
  • NPI 1992231799

  Hospital

  Care Compare affiliation
• St. Joseph Hospital LLC

  dba St. Joseph Regional Medical Center

  • General Acute Care Hospital
  • Lewiston, ID
  • NPI 1225090954
  Care Compare affiliation

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

{
    "created_epoch": "1255564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1124353719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 189",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994030189",
            "telephone_number": "509-758-1119",
            "fax_number": "509-758-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 HIGHLAND AVE STE 7",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032836",
            "telephone_number": "509-758-1119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "627 6th Ave",
            "address_purpose": "LOCATION",
            "city": "Lewiston",
            "state": "ID",
            "postal_code": "835012424",
            "country_code": "US",
            "telephone_number": "208-746-7784",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITLOCK",
        "first_name": "BRANDON",
        "middle_name": "LANE",
        "credential": "AG-ACNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-10-15",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "65287",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61081911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Weis
• Hannah Jean Weiss, DC
• Julian Welz
• Cynthia Jean Wendt, PHARMACIST
• Newton Kirke White, MD
• Stephanie P Whitlock, NP
• Daniel Whittlesey, DDS
• Lear Anthony Wickens, RPH
• Dana Majors Wiggins
• Amanda Wilkins

• Family Nurse Practitioner in Clarkston, WA
• Providers in Clarkston, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.