Active NPI
Forrest Sutton Whitaker, MD
- Pediatrics Physician
- Fayetteville, NC
National Provider Identifier
1336198548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 2013-01825
- Practice address
- 3351 S Peak Dr Ste 101
Fayetteville, NC 28306-9693 - Phone
- (910) 908-4673
- Fax
- (910) 908-2201
- NPI assigned
- May 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | A49616 | CA | |
| Pediatrics Physician | 208000000X | 2013-01825 | NC | Primary |
Addresses
Primary practice location
3351 S Peak Dr Ste 101
Fayetteville, NC 28306-9693
Mailing address
3351 S Peak Dr Ste 101
Fayetteville, NC 28306-9693
Phone (910) 908-4673
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A49616 | CA | MD | Pediatrics Physician |
| 2013-01825 | NC | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647475200000",
"number": "1336198548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3351 S PEAK DR STE 101",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283069693",
"telephone_number": "910-908-4673",
"fax_number": "910-908-2201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3351 S PEAK DR STE 101",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283069693",
"telephone_number": "910-908-4673",
"fax_number": "910-908-2201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITAKER",
"first_name": "FORREST",
"middle_name": "SUTTON",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-08",
"last_updated": "2022-03-17",
"certification_date": "2022-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "A49616",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NC",
"license": "2013-01825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.