Theodore M. Whitaker, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

R1D87 Issued in MO

Practice address

12140 Nall Ave Ste 100
Overland Park, KS 66209-2504

Phone

(816) 943-0406

Fax

(913) 451-1754

NPI assigned

Oct 31, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: theodore.whitaker@hca2.eclinicaldirectplus.com

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.

• Statland Clinic LTD

  • Internal Medicine Physician
  • Overland Park, KS
  • NPI 1487679098
  NPD (past)

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1164413167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12140 NALL AVE STE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662092504",
            "telephone_number": "816-943-0406",
            "fax_number": "913-451-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12140 NALL AVE STE 100",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662092504",
            "telephone_number": "816-943-0406",
            "fax_number": "913-451-1754"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6420 Prospect Avenue",
            "address_2": "Suite T101",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641321186",
            "country_code": "US",
            "telephone_number": "816-363-4100 x223",
            "fax_number": "816-363-8201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6420 Prospect Avenue",
            "address_2": "Suite T101",
            "address_purpose": "LOCATION",
            "city": "Kansas City",
            "state": "MO",
            "postal_code": "641321186",
            "country_code": "US",
            "telephone_number": "816-363-4100 x223",
            "fax_number": "816-363-8201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "THEODORE",
        "middle_name": "M.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "R1D87",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "242039642",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richelle Marie Wheeler, ARNP
• Sean M Wheeler, M.D.
• Timothy Scott Wheeler, LA.C.
• Kimberly Wherry Roys, MD
• James H Whitaker, M.D.
• Maria Antoinette Whitcomb, APRN, FNP
• White Paper LLC
• Claire D White, MD
• Heather Lynne White, APRN, ACNPC-AG
• James White III

• Internal Medicine Physician in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Internal Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.