Individual provider Active NPI

Caleb McCarley Whitson, CRNP

  • Nurse Practitioner
  • Vestavia, AL
National Provider Identifier
1265982524
Registry record updated Aug 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
1-146092 Issued in AL
Practice address
3104 Blue Lake Dr
Suite 110
Vestavia, AL 35243-2345
Phone
(334) 247-8769
Fax
(334) 377-4417
NPI assigned
Oct 11, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 1-146092 AL Primary

Addresses

Primary practice location

3104 Blue Lake Dr
Suite 110
Vestavia, AL 35243-2345

Mailing address

3104 Blue Lake Dr
Vestavia, AL 35243-2345
Phone (334) 247-8769

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161219002852 AL Practitioner - Nurse Practitioner 0749561371 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1-146092ALMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiologists Associated PC CurrentSince Oct 11, 2016 Accepting new patients
Signify Health, LLC Nurse Practitioner CurrentSince Dec 8, 2021 Accepting new patients

Locations

4000 Eagle Point Corporate Dr
Birmingham, AL 35242
Phone (205) 317-0280

701 Princeton Ave SW
Ste Crs
Birmingham, AL 35211

701 Princeton Ave SW
Birmingham, AL 35211
Phone (205) 279-2860

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

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": "1476144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628726400000",
    "number": "1265982524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3104 BLUE LAKE DR",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352432345",
            "telephone_number": "334-247-8769",
            "fax_number": "334-377-4417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 BLUE LAKE DR",
            "address_2": "SUITE 110",
            "city": "VESTAVIA",
            "state": "AL",
            "postal_code": "352432345",
            "telephone_number": "334-247-8769",
            "fax_number": "334-377-4417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITSON",
        "first_name": "CALEB",
        "middle_name": "MCCARLEY",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-10-11",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-146092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vestavia, AL

Sources for this page

Verify at the official NPI Registry.