Individual provider Active NPI

Jonathan David Wheatley, M.D.

  • Emergency Medicine Physician
  • Temple, TX
National Provider Identifier
1174818348
Registry record updated Oct 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
P7050 Issued in TX
Practice address
2401 S 31St St
Temple, TX 76508-7115
Phone
(254) 724-2111
NPI assigned
Jun 15, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X BP10040571 TX
Emergency Medicine Physician 207P00000X P7050 TX Primary

Addresses

Primary practice location

2401 S 31St St
Temple, TX 76508-7115

Mailing address

2401 S. 31St Street
Temple, TX 76508
Phone (254) 724-2111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AZ2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20131106000800 TX Practitioner - Emergency Medicine 3476788084 Reassigns benefits to 2 organizations
I20221118000557 AZ Practitioner - Emergency Medicine 3476788084 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
BP10040571TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tec Emergency Physicians of Arizona, LLC CurrentSince Jun 14, 2022 Accepting new patients
Travis County Emergency Physicians PA Emergency Medicine CurrentSince Nov 1, 2018 Accepting new patients
Concord Medical Group of Texas PLLC Emergency Medicine CurrentSince Jan 17, 2014 Accepting new patients
Concord Medical Group PLLC Emergency Medicine CurrentSince Jan 17, 2014 Accepting new patients

Locations

1064 E Ray Rd
Chandler, AZ 85225
Phone (480) 494-5100

1419 W Hunt Hwy
San Tan Vly, AZ 85143
Phone (480) 245-4300

5125 S Rural Rd
Tempe, AZ 85282
Phone (480) 306-8780

7900 Ranch Road 1826
Austin, TX 78737
Phone (512) 324-5305

310 W South St
Henrietta, TX 76365
Phone (806) 647-2191

2615 Southwest Fwy
Ste 140
Houston, TX 77098
Phone (713) 441-2779

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

1310 E League City Pkwy
League City, TX 77573
Phone (346) 427-5050

11525 Broadway St
Pearland, TX 77584
Phone (713) 363-8020

305 N McKinney St
Sweeny, TX 77480
Phone (979) 548-1500

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

6901 Medical Pkwy
Waco, TX 76712
Phone (254) 751-4000

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": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382054400000",
    "number": "1174818348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 S. 31ST STREET",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "76508",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765087115",
            "telephone_number": "254-724-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEATLEY",
        "first_name": "JONATHAN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-15",
        "last_updated": "2013-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "BP10040571",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "P7050",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.