Individual provider Active NPI

Whitney L. Cline, DO

  • Pediatrics Physician
  • Osage Beach, MO
National Provider Identifier
1275670101
Registry record updated May 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2021047083 Issued in MO
Practice address
3870 Columbia Ave
Osage Beach, MO 65065-8689
Phone
(573) 302-7490
NPI assigned
Jan 31, 2007
Last updated
May 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 4393 OK
Pediatrics Physician 208000000X 0541435 KS
Pediatrics Physician 208000000X 2021047083 MO Primary
Neonatal-Perinatal Medicine Physician 2080N0001X 4393 OK

Addresses

Primary practice location

3870 Columbia Ave
Osage Beach, MO 65065-8689

Mailing address

PO Box 777
Richland, MO 65556-0777
Phone (573) 677-4425

Other practice location 1

1400 W 4th St Ste 100
Coffeyville, KS 67337-3306
Phone (620) 688-6566

Other identifiers 1

IdentifierTypeStateIssuer
200108640AMedicaidOK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211130001911 MO Practitioner - Pediatric Medicine 0749534931 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0541435KSMDPediatrics Physician
2021047083MOMDPediatrics Physician
4393OKMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coffeyville Regional Medical Center Inc Past Accepting new patients
Richland Medical Center, Inc. Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652659200000",
    "number": "1275670101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 777",
            "city": "RICHLAND",
            "state": "MO",
            "postal_code": "655560777",
            "telephone_number": "573-677-4425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3870 COLUMBIA AVE",
            "city": "OSAGE BEACH",
            "state": "MO",
            "postal_code": "650658689",
            "telephone_number": "573-302-7490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1400 W 4th St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Coffeyville",
            "state": "KS",
            "postal_code": "673373306",
            "country_code": "US",
            "telephone_number": "620-688-6566",
            "fax_number": "620-688-6577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLINE",
        "first_name": "WHITNEY",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2022-05-16",
        "certification_date": "2022-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "4393",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KS",
            "license": "0541435",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2021047083",
            "primary": true
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "OK",
            "license": "4393",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200108640A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Osage Beach, MO

Sources for this page

Verify at the official NPI Registry.