Individual provider Active NPI

Daniel Adrian Whitelocke, M.D.

  • Family Medicine Physician
  • Hampton, AR
National Provider Identifier
1255626602
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E8491 Issued in AR
Practice address
402 S Lee St
Hampton, AR 71744-8615
Phone
(870) 798-4064
Fax
(870) 798-4100
NPI assigned
Jun 14, 2011
Last updated
Jul 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X E8491 AR Primary

Addresses

Primary practice location

402 S Lee St
Hampton, AR 71744-8615

Mailing address

1404 W Centennial Dr
Rogers, AR 72758-5763
Phone (901) 649-8755

Other practice location 1

901 Madison Ave
Memphis, TN 38103-3402
Phone (901) 448-7635

Other practice location 2

901 Madison Ave
Memphis, TN 38103-3402
Phone (901) 448-7635

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
E8491ARMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1255626602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 W CENTENNIAL DR",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "727585763",
            "telephone_number": "901-649-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S LEE ST",
            "city": "HAMPTON",
            "state": "AR",
            "postal_code": "717448615",
            "telephone_number": "870-798-4064",
            "fax_number": "870-798-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381033402",
            "country_code": "US",
            "telephone_number": "901-448-7635",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "901 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381033402",
            "country_code": "US",
            "telephone_number": "901-448-7635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITELOCKE",
        "first_name": "DANIEL",
        "middle_name": "ADRIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-14",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E8491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; 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.