Individual provider Active NPI

Zackary Whitley, MSN, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Austin, TX
National Provider Identifier
1154109874
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
2023101951 Issued in TX
Practice address
5339 N Ih 35 Ste 100
Austin, TX 78723-2558
Phone
(512) 978-8130
NPI assigned
Sep 15, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 2023101951 TX Primary

Addresses

Primary practice location

5339 N Ih 35 Ste 100
Austin, TX 78723-2558

Mailing address

1111 E Cesar Chavez St
Austin, TX 78702-4209

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240127000277 TX Practitioner - Nurse Practitioner 9537512470 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2023101951TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Travis County Healthcare District CurrentSince Jun 30, 2025 Accepting new patients
Seton Family of Doctors CurrentSince Dec 18, 2023 Accepting new patients
Seton Family of Doctors CurrentSince Dec 18, 2023 Accepting new patients
Community Care Collaborative PastSince Jun 29, 2025 Accepting new patients

Locations

1201 W 38th St
Austin, TX 78705
Phone (512) 324-1058

1500 Red River St
Austin, TX 78701
Phone (512) 324-0150

1400 N Interstate 35
Ste 300
Austin, TX 78701
Phone (512) 324-8300

1111 E Cesar Chavez St
Austin, TX 78702
Phone (512) 978-8000

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": "1694736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1154109874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 E CESAR CHAVEZ ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787024209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5339 N IH 35 STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787232558",
            "telephone_number": "512-978-8130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLEY",
        "first_name": "ZACKARY",
        "credential": "MSN, AGACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-15",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "2023101951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.