Individual provider Active NPI

Stephanie Whitko, MD

  • Internal Medicine Physician
  • Beachwood, OH
National Provider Identifier
1245330539
Registry record updated Jun 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
OOH35084265 Issued in OH
Practice address
3909 Orange PL Ste 2100
Beachwood, OH 44122-8400
Phone
(216) 896-1800
Fax
(216) 896-1801
NPI assigned
Sep 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X OOH35084265 OH Primary
Pediatrics Physician 208000000X OH35084265 OH

Addresses

Primary practice location

3909 Orange PL Ste 2100
Beachwood, OH 44122-8400

Mailing address

24701 Euclid Ave
Third Floor Billing Services
Euclid, OH 44117-1714
Phone (216) 896-1800

Other identifiers 1

IdentifierTypeStateIssuer
2493056MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OOH35084265OHMDInternal Medicine Physician
OH35084265OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc Past Accepting new patients
University Primary Care Practices Inc Internal Medicine Past Accepting new patients

Organizations & group practices 2

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": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372377600000",
    "number": "1245330539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24701 EUCLID AVE",
            "address_2": "THIRD FLOOR BILLING SERVICES",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441171714",
            "telephone_number": "216-896-1800",
            "fax_number": "216-896-1801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 ORANGE PL STE 2100",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441228400",
            "telephone_number": "216-896-1800",
            "fax_number": "216-896-1801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITKO",
        "first_name": "STEPHANIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2013-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "OOH35084265",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "OH35084265",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2493056",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2013; 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.