Individual provider Active NPI

Norris Walter Whitlock, M.D.

  • Urology Physician
  • Greenville, SC
National Provider Identifier
1386628956
Registry record updated Dec 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
9586 Issued in SC
Practice address
3523 Pelham Rd
Suite C
Greenville, SC 29615-4191
Phone
(864) 306-0966
Fax
(864) 306-2544
NPI assigned
Dec 6, 2005
Last updated
Dec 23, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 9586 SC Primary

Addresses

Primary practice location

3523 Pelham Rd
Suite C
Greenville, SC 29615-4191

Mailing address

PO Box 14611
Greenville, SC 29610-4611
Phone (864) 306-0966

Other identifiers 1

IdentifierTypeStateIssuer
095863MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110826000737 SC Practitioner - Urology 6406026574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Medical University of South Carolina College of Medicine, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Geriatrics, Inc.Group PAC ID 0941271035, 11 clinicians

Practice addresses (Care Compare)

Greenville, SC 29615
Phone (864) 306-0966

810 E Butler Rd
Greenville, SC 29607-5842
Phone (864) 627-0803

850 E Butler Rd
Greenville, SC 29607-5842
Phone (864) 675-6421

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.74 of 100Reported as group
Quality
83.33
Improvement activities
40
Cost
51.35

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
9586SCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Geriatrics, Inc. CurrentSince Aug 26, 2013 Accepting new patients

Locations

3523 Pelham Rd
Ste C
Greenville, SC 29615
Phone (864) 306-0966

850 E Butler Rd
Greenville, SC 29607
Phone (864) 306-0966

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1386628956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14611",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296104611",
            "telephone_number": "864-306-0966",
            "fax_number": "864-306-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3523 PELHAM RD",
            "address_2": "SUITE C",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154191",
            "telephone_number": "864-306-0966",
            "fax_number": "864-306-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLOCK",
        "first_name": "NORRIS",
        "middle_name": "WALTER",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "SC",
            "license": "9586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "095863",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.