Individual provider Active NPI

Carol A Whitman, MD

  • Psychiatry Physician
  • Fargo, ND
National Provider Identifier
1346861473
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
17773 Issued in ND
Practice address
510 4TH St S
Fargo, ND 58103-1914
Phone
(605) 400-8680
NPI assigned
Apr 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 17773 ND Primary

Addresses

Primary practice location

510 4TH St S
Fargo, ND 58103-1914

Mailing address

510 4TH St S
Fargo, ND 58103-1914
Phone (605) 400-8680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20211220002542 ND Practitioner - Psychiatry 4981021805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
PSJ Acquisition LLC 26 clinicians

Practice addresses (Care Compare)

510 4TH St S
Fargo, ND 58103-1914
Phone (701) 476-7200

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
PSJ Acquisition LLC Psychiatry CurrentSince Oct 20, 2021 Accepting new patients
PSJ Acquisition LLC CurrentSince Oct 20, 2021 Accepting new patients

Locations

510 4th St S
Fargo, ND 58103
Phone (701) 476-7200

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1588118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1346861473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 4TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031914",
            "telephone_number": "605-400-8680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 4TH ST S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581031914",
            "telephone_number": "605-400-8680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITMAN",
        "first_name": "CAROL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-29",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ND",
            "license": "17773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fargo, ND

Sources for this page

Verify at the official NPI Registry.