Shirley A Whitaker, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

59030 Issued in MA

Practice address

2150 Main St
Springfield, MA 01104-3566

Phone

(413) 733-0010

Fax

(413) 930-2108

NPI assigned

Nov 9, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shirley A Jackson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Renal and Transplant Associates of New England PC

  • Nephrology Physician
  • Springfield, MA
  • NPI 1235535204
  NPD

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376524199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 366",
            "city": "LUDLOW",
            "state": "MA",
            "postal_code": "010560366",
            "telephone_number": "413-733-0010",
            "fax_number": "413-930-2108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2150 MAIN ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011043566",
            "telephone_number": "413-733-0010",
            "fax_number": "413-930-2108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "SHIRLEY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MA",
            "license": "59030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0195031",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHIRLEY",
            "last_name": "JACKSON",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Timothy Whelan, PHD
• Lauren A Whelihan, LICSW
• Candice Kristine Wherry, DPT
• Jevan Whitaker
• Kayleen Ariana Whitaker, LPN
• Alicia White, RN
• Alisha White
• Brandon White
• Jasmine White
• Keonderick A. White

• Nephrology Physician in Springfield, MA
• Providers in Springfield, MA by specialty
• Nephrology Physician in Massachusetts

• 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.
• 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.