Individual provider Active NPI

Kevin E Whitton, DPM

  • Foot & Ankle Surgery Podiatrist
  • Missoula, MT
National Provider Identifier
1366424186
Registry record updated Oct 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
MED-POD-LIC-33740 Issued in MT
Practice address
110 South Ave W
Missoula, MT 59801-8116
Phone
(706) 766-3683
NPI assigned
Nov 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X 000459 GA
Foot & Ankle Surgery Podiatrist 213ES0103X MED-POD-LIC-33740 MT Primary

Addresses

Primary practice location

110 South Ave W
Missoula, MT 59801-8116

Mailing address

110 South Ave W
Missoula, MT 59801-8116
Phone (706) 766-3683

Other identifiers 2

IdentifierTypeStateIssuer
MED-POD-LIC-33740OtherMTLICENSE
000459OtherGASTATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141219000205 MT Practitioner - Podiatry 1759377856 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
000459GAMDFoot & Ankle Surgery Podiatrist
MED-POD-LIC-33740MTMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Foot & Ankle Center LLC Foot & Ankle Surgery CurrentSince Oct 1, 2014 Accepting new patients

Locations

110 South Ave W
Missoula, MT 59801
Phone (406) 542-2108

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

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": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412553600000",
    "number": "1366424186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 SOUTH AVE W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018116",
            "telephone_number": "706-766-3683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SOUTH AVE W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018116",
            "telephone_number": "706-766-3683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTON",
        "first_name": "KEVIN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-17",
        "last_updated": "2014-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "GA",
            "license": "000459",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MT",
            "license": "MED-POD-LIC-33740",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "MED-POD-LIC-33740",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "000459",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.