Cory Mitchell Whitlock, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1821 Issued in NV

Practice address

2481 W Horizon Ridge Pkwy Ste 100
Henderson, NV 89052-5926

Phone

(775) 848-6971

Fax

(702) 680-1377

NPI assigned

Sep 14, 2015

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Psychiatry of Texas PLLC

  • Psychiatry Physician
  • Houston, TX
  • NPI 1013476027

  NV

  Medicare reassignment
• Psychplus Medical Associates, PLLC

  • Family Medicine Physician
  • Houston, TX
  • NPI 1558118026

  NV

  Medicare reassignment
• Psychplus Medical Associates of Michigan, PLLC

  • Internal Medicine Physician
  • Dearborn, MI
  • NPI 1851144877
  NPD (past)

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

{
    "created_epoch": "1442188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746057600000",
    "number": "1205204781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 BLACKRIDGE RD",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890157632",
            "telephone_number": "775-848-6971",
            "fax_number": "702-680-1377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2481 W HORIZON RIDGE PKWY STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525926",
            "telephone_number": "775-848-6971",
            "fax_number": "702-680-1377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4311 11th Ave NE",
            "address_2": "200",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981056366",
            "country_code": "US",
            "telephone_number": "206-616-4001",
            "fax_number": "206-616-3889",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "639 Isbell Rd Ste 380",
            "address_purpose": "LOCATION",
            "city": "Reno",
            "state": "NV",
            "postal_code": "895094982",
            "country_code": "US",
            "telephone_number": "832-869-4818",
            "fax_number": "832-241-2902",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITLOCK",
        "first_name": "CORY",
        "middle_name": "MITCHELL",
        "credential": "PAC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-14",
        "last_updated": "2025-05-01",
        "certification_date": "2025-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "NV",
            "license": "PA1821",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Ann White, LMSW, CSW-I
• Amanda Whitear, RN
• Debra Whiters
• Stuart Maurice Whitfield
• Amber Whitley
• Ebony S Whitney
• Lashyla Whitney
• Mark Whitney, DPT
• Why Not Therapy LLC
• Yolanda Wibowo, CPC- I

• Physician Assistant in Henderson, NV
• Providers in Henderson, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.