Individual provider Active NPI

Thomas Brian Whalen, M.D.

  • General Practice Physician
  • Gainesville, FL
National Provider Identifier
1366460990
Registry record updated Mar 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME90007 Issued in FL
Practice address
3703 SW 13TH St
Gainesville, FL 32608-3507
Phone
(352) 672-8023
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 19, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME90007 FL Primary
Anesthesiology Physician 207L00000X ME90007 FL

Addresses

Primary practice location

3703 SW 13TH St
Gainesville, FL 32608-3507

Mailing address

5120 NW 67TH St
Gainesville, FL 32653-3949
Phone (352) 672-8023

Other identifiers 1

IdentifierTypeStateIssuer
269502200MedicaidFL

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)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Clearwater Pain Management Associates Anesthesiology Past Accepting new patients
Capitol Anesthesiology, PC Anesthesiology Past Accepting new patients
Gate City Anesthesia, Inc Anesthesiology Past Accepting new patients
Anesthesia Associates of Pinellas County Past Accepting new patients
Advanced Anesthesia Associates LLC Anesthesiology Past Accepting new patients
Anesthesiology Consultants of the Palm Beaches PA Anesthesiology PastSince Jan 19, 2004 Accepting new patients

Organizations & group practices 6

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426723200000",
    "number": "1366460990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5120 NW 67TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326533949",
            "telephone_number": "352-672-8023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3703 SW 13TH ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326083507",
            "telephone_number": "352-672-8023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHALEN",
        "first_name": "THOMAS",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2015-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME90007",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME90007",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269502200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.