Jeffrey Bray Whitehurst, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

18421 Issued in AL

Practice address

112 Haven Drive
Suite 1
Dothan, AL 36301

Phone

(334) 671-5050

Fax

(334) 671-5070

NPI assigned

Sep 12, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

University of Alabama School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Houston County Healthcare AuthorityGroup PAC ID 9436062296, 256 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Houston County Healthcare Authority

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1164403861

  Corporate Director

  CMS ownership

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.

• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606
  Medicare reassignment Care Compare group NPD
• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1285783134
  NPD
• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1538597349
  NPD
• Houston County Healthcare Authority

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1164403861
  NPD (past)
• Southeast Alabama Medical Center Employee Pharmacy

  • Pharmacy
  • Dothan, AL
  • NPI 1053526368
  NPD (past)
• Hospital Authority of the City of Bainbridge and Decatur County

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256
  NPD (past)
• Surgical Associates of Albany PC

  • Surgery Physician
  • Albany, GA
  • NPI 1447284781
  NPD (past)

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

• Houston County Healthcare Authority

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1164403861
  Care Compare affiliation

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268870400000",
    "number": "1154316586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 HAVEN DRIVE",
            "address_2": "SUITE 1",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36301",
            "telephone_number": "334-671-5050",
            "fax_number": "334-671-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 HAVEN DRIVE",
            "address_2": "SUITE 1",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "36301",
            "telephone_number": "334-671-5050",
            "fax_number": "334-671-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHURST",
        "first_name": "JEFFREY",
        "middle_name": "BRAY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2010-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "18421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051510147",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00793163B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lyndsey Marie White
• Kara Horne Whitehead, OTR/L
• Sarah Whitehead, OTR/L
• Whitehurst Companion Care Associates
• Whitehurst General Surgery PC
• Patrick F Whitney, MD
• Keshia Latrell Whittaker-Rivers, MSN, CRNP, PMHNP-BC
• Raylee Ann Whitten
• Elizabeth Stokes Wiggins, RPH
• Ronnie D Wiggins, MD

• Surgery Physician in Dothan, AL
• Providers in Dothan, AL by specialty
• Surgery Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.