NPIMap

Individual provider Active NPI

Nathaniel Robb Whaley, MD

  • Neurology Physician
  • Johnson City, TN
National Provider Identifier
1245213545
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD44490 Issued in TN
Practice address
1321 Sunset Drive
Suite 11
Johnson City, TN 37604-7902
Phone
(423) 928-6174
Fax
(423) 926-2258
NPI assigned
Nov 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X ME91623 FL
Neurology Physician 2084N0400X MD44490 TN Primary

Addresses

Primary practice location

1321 Sunset Drive
Suite 11
Johnson City, TN 37604-7902

Mailing address

1321 Sunset Drive
Suite 11
Johnson City, TN 37604-7902
Phone (423) 928-6174

Other names 1

  • Dr. N. R. Whaley Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090727000811 TN Practitioner - Neurology 4284787011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
East Tennessee State University Quillen College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri State Mountain Neurology Associates PCGroup PAC ID 4587753892, 4 clinicians

Practice addresses (Care Compare)

1321 Sunset Dr
Suite 11
Johnson City, TN 37604-7902
Phone (423) 928-6174

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME91623FLMDNeurology Physician
MD44490TNMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri State Mountain Neurology Associates PC Neurology CurrentSince Aug 10, 2009 Accepting new patients

Locations

1321 Sunset Dr
Ste 11
Johnson City, TN 37604
Phone (423) 928-6174

Organizations & group practices 1

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1245213545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 SUNSET DRIVE",
            "address_2": "SUITE 11",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376047902",
            "telephone_number": "423-928-6174",
            "fax_number": "423-926-2258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 SUNSET DRIVE",
            "address_2": "SUITE 11",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376047902",
            "telephone_number": "423-928-6174",
            "fax_number": "423-926-2258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALEY",
        "first_name": "NATHANIEL",
        "middle_name": "ROBB",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-22",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME91623",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TN",
            "license": "MD44490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "N.",
            "last_name": "WHALEY",
            "middle_name": "R.",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.