Tiquella Shantel King-Whitby, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

58891 Issued in GA

Practice address

685 Arlington PL
Macon, GA 31201-1772

Phone

(478) 292-2060

NPI assigned

Feb 5, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Shantel King-Whitby Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Function & Health Professionals LLC

  • Medical Specialty Clinic/Center
  • Macon, GA
  • NPI 1376917591
  NPD (past) Authorized official
• Central Georiga Fertility Institute

  • Reproductive Endocrinology Physician
  • Macon, GA
  • NPI 1447390901

  Single Specialty

  NPD (past)
• Health Services of Central Georgia, Inc

  • Multi-Specialty Clinic/Center
  • Macon, GA
  • NPI 1184679482

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1202169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1366620957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "685 ARLINGTON PL",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312011772",
            "telephone_number": "478-292-2060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "685 ARLINGTON PL",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312011772",
            "telephone_number": "478-292-2060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3351 Northside Dr",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312102587",
            "country_code": "US",
            "telephone_number": "478-201-6539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING-WHITBY",
        "first_name": "TIQUELLA",
        "middle_name": "SHANTEL",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "058891",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "58891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANTEL",
            "last_name": "KING-WHITBY",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christina Kinder, MD
• Dean D Kindler, MD
• King Family Eye Care,LLC
• Charisse M King Tharpe
• Erin M King-Mullins, M.D.
• Andrew R King, M.D.
• Christine Yunn King, DO
• John Wesley King Jr., M.D.
• Lakeyshia Nix King, NP-C
• Lisa Marian King, M.D.

• Physical Medicine & Rehabilitation Physician in Macon, GA
• Providers in Macon, GA by specialty
• Physical Medicine & Rehabilitation Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.