NPIMap

Individual provider Active NPI

Kevin Glen Wherry, M.D.

  • Internal Medicine Physician
  • McMinnville, OR
National Provider Identifier
1376869941
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD167037 Issued in OR
Practice address
2435 NE Cumulus Ave Ste a
McMinnville, OR 97128-8805
Phone
(503) 472-6161
Fax
(503) 434-6290
NPI assigned
Apr 8, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD167037 OR
Internal Medicine Physician 207R00000X MD167037 OR Primary

Addresses

Primary practice location

2435 NE Cumulus Ave Ste a
McMinnville, OR 97128-8805

Mailing address

2435 NE Cumulus Ave Ste a
McMinnville, OR 97128-8805
Phone (503) 472-6161

Other identifiers 1

IdentifierTypeStateIssuer
500675027MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141027000084 OR Practitioner - Internal Medicine 3678794120 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Washington School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physicians Medical Center P CGroup PAC ID 6305832890, 21 clinicians

Practice addresses (Care Compare)

2435 NE Cumulus Ave
Suite a
McMinnville, OR 97128-8805
Phone (503) 472-6161

Hospital & facility affiliations

  • Willamette Valley Medical Center Hospital, McMinnville, OR, CCN 380071
  • Samaritan North Lincoln Hospital Hospital, Lincoln City, OR, CCN 381302
  • Providence Newberg Medical Center Hospital, Newberg, OR, CCN 380037
  • Salem Health West Valley Hospital, Dallas, OR, CCN 381308
  • Salem Hospital Hospital, Salem, OR, CCN 380051

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD167037ORMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Medical Center, P C Current Accepting new patients
Physicians Medical Center P C CurrentSince Jul 21, 2020 Accepting new patients
Willamette Valley Clinics LLC Internal Medicine CurrentSince Mar 1, 2021 Accepting new patients

Locations

2700 SE Stratus Ave
Unit 402
McMinnville, OR 97128
Phone (503) 434-1110

2435 NE Cumulus Ave
Ste A
McMinnville, OR 97128
Phone (503) 472-6161

2700 SE Stratus Ave
McMinnville, OR 97128
Phone (503) 435-1200

Organizations & group practices 3

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.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1376869941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 NE CUMULUS AVE STE A",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971288805",
            "telephone_number": "503-472-6161",
            "fax_number": "503-434-6290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2435 NE CUMULUS AVE STE A",
            "city": "MCMINNVILLE",
            "state": "OR",
            "postal_code": "971288805",
            "telephone_number": "503-472-6161",
            "fax_number": "503-434-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHERRY",
        "first_name": "KEVIN",
        "middle_name": "GLEN",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-08",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OR",
            "license": "MD167037",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD167037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500675027",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McMinnville, OR

Sources for this page

Verify at the official NPI Registry.