Kelly Walsh Whiteley, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

10959 Issued in NC

Practice address

450 New Market Blvd Ste 2
Boone, NC 28607

Phone

(828) 265-1112

NPI assigned

Jul 30, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Julia Tyson Snyder, D.D.S., P.a.

  • General Practice Dentistry
  • Boone, NC
  • NPI 1528330289
  NPD
• Brushy MTN Sleep Solutions LLC

  • General Practice Dentistry
  • North Wilkesboro, NC
  • NPI 1831953868
  NPD (past)

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596931200000",
    "number": "1346625431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 NEW MARKET BLVD STE 2",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "286075501",
            "telephone_number": "828-265-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 NEW MARKET BLVD STE 2",
            "city": "BOONE",
            "state": "NC",
            "postal_code": "28607",
            "telephone_number": "828-265-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITELEY",
        "first_name": "KELLY",
        "middle_name": "WALSH",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-30",
        "last_updated": "2020-08-09",
        "certification_date": "2020-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NV",
            "license": "6777",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "10959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Western Youth Network, Inc
• Aaron A Westphal, M.D.
• Alexis Nicole Whalley, MOT, OTR/L
• Stephanie Conner Whigham, M.S., OTR/L
• Adam Brock Whiteley, DMD, MS
• John Lee Whitlock, M.D.
• Kimberly Brooke Whitman, MSSW, LCSW, LCASA
• Sierra Melina-Victoria Whitmire
• Marc Hamilton Whitt I, PTA
• David Stanton Whittaker Jr., MD

• General Practice Dentistry in Boone, NC
• Providers in Boone, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.