Individual provider Active NPI

John Louis Whitehead, DO

  • Surgical Critical Care Physician
  • Bay Harbor Islands, FL
National Provider Identifier
1275772295
Registry record updated Jul 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
OS13461 Issued in FL
Practice address
1111 Kane Concourse Ste 311
Bay Harbor Islands, FL 33154-2041
Phone
(305) 865-2000
Fax
(305) 865-2002
NPI assigned
Feb 14, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X OS13461 FL Primary

Addresses

Primary practice location

1111 Kane Concourse Ste 311
Bay Harbor Islands, FL 33154-2041

Mailing address

1111 Kane Concourse Ste 311
Bay Harbor Islands, FL 33154-2041
Phone (305) 865-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20130909000174 NJ Practitioner - General Surgery 9234372491 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Barnabas Health Medical Group PC CurrentSince Jul 21, 2015 Accepting new patients
Barnabas Health Medical Group PC CurrentSince Jul 21, 2015 Accepting new patients

Locations

355 Grand St
Jersey City, NJ 07302
Phone (201) 915-2224

475 Route 70
Ste 101
Lakewood, NJ 08701
Phone (732) 364-8000

94 Old Short Hills Rd
Livingston, NJ 07039
Phone (973) 322-5400

Interoperability endpoints

  • Direct secure messaging: jwhitehead200143@mhsdirect.net

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": "1234569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1275772295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 KANE CONCOURSE STE 311",
            "city": "BAY HARBOR ISLANDS",
            "state": "FL",
            "postal_code": "331542041",
            "telephone_number": "305-865-2000",
            "fax_number": "305-865-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 KANE CONCOURSE STE 311",
            "city": "BAY HARBOR ISLANDS",
            "state": "FL",
            "postal_code": "331542041",
            "telephone_number": "305-865-2000",
            "fax_number": "305-865-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "JOHN",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-02-14",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "FL",
            "license": "OS13461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Harbor Islands, FL

Sources for this page

Verify at the official NPI Registry.