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

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 Hospital 33 clinicians

St Joseph Hospital LLC 91 clinicians

Meza Post Acute and Long Term Care PLLC 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 and National Provider Directory roles.

• Tri-State Memorial Hospital

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1598814352

  ID, WA

  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

  ID, WA

  Medicare reassignment Care Compare group NPD
• St Joseph Hospital LLC

  • Internal Medicine Physician
  • Lewiston, ID
  • NPI 1043744287

  WA

  Medicare reassignment Care Compare group NPD
• St Joseph Hospital LLC

  • Internal Medicine Physician
  • Lewiston, ID
  • NPI 1205368404

  ID

  Medicare reassignment Care Compare group NPD
• Tri-State Memorial Hospital

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1760485221

  WA

  Medicare reassignment Care Compare group
• Vannvei LLC

  • Multi-Specialty Clinic/Center
  • Lewiston, ID
  • NPI 1881200517

  ID

  Medicare reassignment NPD
• Tri-State Memorial Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Clarkston, WA
  • NPI 1174697353
  Care Compare group
• St Joseph Hospital LLC

  • Durable Medical Equipment & Medical Supplies
  • Lewiston, ID
  • NPI 1982553855
  Care Compare group
• St. Joseph Hospital LLC

  • General Acute Care Hospital
  • Lewiston, ID
  • NPI 1225090954
  Care Compare group
• St. Joseph Hospital, LLC

  • Psychiatric Hospital Unit
  • Lewiston, ID
  • NPI 1205975851
  Care Compare group
• St. Joseph Hospital, LLC

  • Rehabilitation Hospital Unit
  • Lewiston, ID
  • NPI 1629783295
  Care Compare group
• Tri-State Memorial Hospital

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

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

• Alpowa Healthcare, Inc.

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

  • Critical Access Hospital
  • Clarkston, WA
  • NPI 1760485221

  Hospital

  Care Compare affiliation
• Tri-State Memorial Hospital

  • Family Medicine Physician
  • Clarkston, WA
  • NPI 1932405693

  Hospital

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

  • 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

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

  Hospital

  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

• All providers in Clarkston, WA
• 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.