Individual provider Active NPI

Royal Bradley Whinery, MD

  • Family Medicine Physician
  • Elk City, OK
National Provider Identifier
1336361773
Registry record updated Dec 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
26230 Issued in OK
Practice address
1710 W 3Rd St
Suite 103
Elk City, OK 73644-5159
Phone
(580) 225-1290
Fax
(580) 225-2178
NPI assigned
May 3, 2007
Last updated
Dec 21, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 26230 OK Primary
Family Medicine Physician 207Q00000X 6420 KS

Addresses

Primary practice location

1710 W 3Rd St
Suite 103
Elk City, OK 73644-5159

Mailing address

1710 W 3Rd St
Suite 103
Elk City, OK 73644-5159
Phone (580) 225-1290

Other identifiers 1

IdentifierTypeStateIssuer
200202430AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20080926000559 OK Practitioner - Family Practice 1153498548 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Oklahoma College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Whinery Family Medicine PLLCGroup PAC ID 7517034911, 2 clinicians

Practice addresses (Care Compare)

1721 W Ave a
Elk City, OK 73644-3901
Phone (580) 303-4390

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6420KSMDFamily Medicine Physician
26230OKMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Whinery Family Medicine PLLC Family Medicine CurrentSince Jul 28, 2008 Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

1710 W 3rd St
Ste 103
Elk City, OK 73644
Phone (580) 225-1290

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JHAJBD/Endpoint/JHAJBD

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292889600000",
    "number": "1336361773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 W 3RD ST",
            "address_2": "SUITE 103",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736445159",
            "telephone_number": "580-225-1290",
            "fax_number": "580-225-2178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 W 3RD ST",
            "address_2": "SUITE 103",
            "city": "ELK CITY",
            "state": "OK",
            "postal_code": "736445159",
            "telephone_number": "580-225-1290",
            "fax_number": "580-225-2178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHINERY",
        "first_name": "ROYAL",
        "middle_name": "BRADLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2010-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "26230",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "6420",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200202430A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk City, OK

Sources for this page

Verify at the official NPI Registry.