Individual provider Active NPI

Richard James Whittaker, MD

  • Family Medicine Physician
  • San Antonio, TX
National Provider Identifier
1336146083
Registry record updated Oct 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J8638 Issued in TX
Practice address
6157 NW Loop 410
Ste 124
San Antonio, TX 78238-3302
Phone
(210) 523-1411
Fax
(210) 523-9307
NPI assigned
Jul 7, 2005
Last updated
Oct 18, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X J8638 TX Primary

Addresses

Primary practice location

6157 NW Loop 410
Ste 124
San Antonio, TX 78238-3302

Mailing address

6157 NW Loop 410
Ste 124
San Antonio, TX 78238-3302
Phone (210) 523-1411

Other identifiers 2

IdentifierTypeStateIssuer
0453250-03OtherTXWELLMED MEDICAID
81099GOtherTXWELLMED MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20101026001245 TX Practitioner - Family Practice 0446443121 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
J8638TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmed Medical Group, PA Family Medicine CurrentSince Aug 10, 1998 Accepting new patients
Wellmed Medical Group, P.a. Family Medicine CurrentSince Aug 10, 1998 Accepting new patients

Locations

6157 NW Loop 410
Ste 124
San Antonio, TX 78238
Phone (210) 523-1411

8637 Fredericksburg Rd
Ste 360
San Antonio, TX 78240
Phone (210) 304-3500

Interoperability endpoints

  • Direct secure messaging: richard.whittaker@wellmed.eclinicaldirectplus.com

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, 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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1336146083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6157 NW LOOP 410",
            "address_2": "STE 124",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782383302",
            "telephone_number": "210-523-1411",
            "fax_number": "210-523-9307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6157 NW LOOP 410",
            "address_2": "STE 124",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782383302",
            "telephone_number": "210-523-1411",
            "fax_number": "210-523-9307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTAKER",
        "first_name": "RICHARD",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J8638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED MEDICAID",
            "identifier": "0453250-03",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMED MEDICARE",
            "identifier": "81099G",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.