Samuel Warren Whittaker

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

104 Brighton Knoll CT
Accokeek, MD 20607-2718

Phone

(202) 997-4631

NPI assigned

Mar 9, 2023

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1205536018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 BRIGHTON KNOLL CT",
            "city": "ACCOKEEK",
            "state": "MD",
            "postal_code": "206072718",
            "telephone_number": "202-997-4631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 BRIGHTON KNOLL CT",
            "city": "ACCOKEEK",
            "state": "MD",
            "postal_code": "206072718",
            "telephone_number": "202-997-4631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTAKER",
        "first_name": "SAMUEL",
        "middle_name": "WARREN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-09",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "DC",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "DC",
            "license": "965",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Musu Turay, CRNP
• Kimberly Cecelia Ward, LCSW-C, LICSW
• Washington Educational Consultants (Wec) LLC
• Melody Washington, LCSW-C
• Teresa Whigham, MS, OTR/L
• Cavena Williams
• Marcia Williams
• Natascha Nunn Wilson, MPT

• Case Manager/Care Coordinator in Accokeek, MD
• Providers in Accokeek, MD by specialty
• Case Manager/Care Coordinator in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.