Individual provider Active NPI

Michael Whetstone, PHD

  • Clinical Neuropsychologist
  • Springfield, MO
National Provider Identifier
1306843735
Registry record updated Oct 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
01373 Issued in MO
Practice address
2115 S Fremont Ave Ste 3000
Springfield, MO 65804-2215
Phone
(417) 820-7708
NPI assigned
Jun 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 01373 MO Primary

Addresses

Primary practice location

2115 S Fremont Ave Ste 3000
Springfield, MO 65804-2215

Mailing address

2115 S Fremont Ave Ste 3000
Springfield, MO 65804-2215
Phone (417) 820-7708

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081210000811 MO Practitioner - Clinical Psychologist 8325109226 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

1235 E Cherokee St
Springfield, MO 65804-2203

2115 S Fremont Ave
3050 MC Infectious Disease Whiteside
Springfield, MO 65804-2236
Phone (417) 820-3905

5904 S Southwood Rd
Mercy Rehab Hospital Springfield
Springfield, MO 65804-5234
Phone (417) 820-2600

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince May 19, 2010 Accepting new patients
Ozark Health Ventures, LLC CurrentSince Aug 1, 2008 Accepting new patients
Ozark Health Ventures, LLC CurrentSince Aug 1, 2008 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince May 19, 2010 Accepting new patients
Mercy Hospital Springfield CurrentSince Nov 1, 2002 Accepting new patients
Mercy Hospital Springfield CurrentSince Nov 1, 2002 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Jul 1, 2014 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

1312 E Lark St
#L
Springfield, MO 65804
Phone (417) 820-3707

2115 S Fremont Ave
Ste 3000
Springfield, MO 65804
Phone (417) 820-7708

620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215

3550 S National Ave
Ste 200
Springfield, MO 65807
Phone (417) 269-9300

2055 S Fremont Ave
#1000
Springfield, MO 65804
Phone (417) 820-8099

Interoperability endpoints

  • Direct secure messaging: mwhetstone11298@directb.mercy.net

Organizations & group practices 8

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": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507161600000",
    "number": "1306843735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 S FREMONT AVE STE 3000",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042215",
            "telephone_number": "417-820-7708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2115 S FREMONT AVE STE 3000",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042215",
            "telephone_number": "417-820-7708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHETSTONE",
        "first_name": "MICHAEL",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-30",
        "last_updated": "2017-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MO",
            "license": "01373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.