John Calvin Whitley Jr., M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

9167 Issued in SC

Practice address

1315 W Martintown Rd
North Augusta, SC 29860-7631

Phone

(803) 640-6544

Fax

(803) 278-7318

NPI assigned

Jul 11, 2009

Last updated

Jul 15, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 3, 2014 through Mar 3, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1247270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247616000000",
    "number": "1316176324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 W MARTINTOWN RD",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298607631",
            "telephone_number": "803-640-6544",
            "fax_number": "803-278-7318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 W MARTINTOWN RD",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298607631",
            "telephone_number": "803-640-6544",
            "fax_number": "803-278-7318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLEY",
        "first_name": "JOHN",
        "middle_name": "CALVIN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-11",
        "last_updated": "2009-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "5088",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "SC",
            "license": "9167",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "17050",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul M Weiner, MD
• Jacquelyn H Wells, LCSW
• Kathryn Michelle Wells, PA-C
• Erica West
• Shellie Chapman White, NP
• Mary Ann Wilkes, RN
• Barbara Phillips Williams, ACSW/LCSW
• Janiya Williams
• Kim Cooper Williams, PHARM.D
• Kirsten Williams

• Psychiatry Physician in North Augusta, SC
• Providers in North Augusta, SC by specialty
• Psychiatry Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.