Organization Active NPI

Robert N Whitaker Jr MD PA

  • Otolaryngic Allergy Physician
  • Salisbury, NC
National Provider Identifier
1205992203
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngic Allergy PhysicianTaxonomy code 207YX0602X
License
9500766 Issued in NC
Legal business name
ROBERT N WHITAKER JR MD PA
Practice address
330 Jake Alexander Blvd West Suite 101
Salisbury, NC 28147
Phone
(704) 637-5668
Fax
(704) 637-5605
NPI assigned
Dec 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert N Whitaker Jr., MDNPI 1255312898
Title
President
Phone
(704) 637-5668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngic Allergy PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207YX0602X 9500766 NC Primary

Addresses

Primary practice location

330 Jake Alexander Blvd West Suite 101
Salisbury, NC 28147

Mailing address

PO Box 5116
330 Jake Alexander Blvd West Suite 101
Salisbury, NC 28147
Phone (704) 637-5668

Other identifiers 1

IdentifierTypeStateIssuer
8986917MedicaidNC

National Provider Directory

National Provider Directory

Locations

330 Jake Alexander Blvd W
Ste 101
Salisbury, NC 28147
Phone (704) 637-5668

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205992203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5116",
            "address_2": "330 JAKE ALEXANDER BLVD WEST SUITE 101",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "28147",
            "telephone_number": "704-637-5668",
            "fax_number": "704-637-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 JAKE ALEXANDER BLVD WEST SUITE 101",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "28147",
            "telephone_number": "704-637-5668",
            "fax_number": "704-637-5605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT N WHITAKER JR MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITAKER",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "704-637-5668",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207YX0602X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology, Otolaryngic Allergy",
            "state": "NC",
            "license": "9500766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8986917",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.