Individual provider Active NPI

Dorothy Whitaker, CRNA

  • Specialist
  • Gallup, NM
National Provider Identifier
1386644052
Registry record updated Mar 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
R067660 Issued in MD
Practice address
516 East Nizhoni Blvd.
Gallup, NM 87301-1337
Phone
(505) 722-1000
Fax
(505) 722-1421
NPI assigned
Jul 26, 2005
Last updated
Mar 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X R067660 MD Primary

Addresses

Primary practice location

516 East Nizhoni Blvd.
Gallup, NM 87301-1337

Mailing address

PO Box 1337
Gallup, NM 87305-1337
Phone (505) 722-1000

Other identifiers 1

IdentifierTypeStateIssuer
401790100MedicaidMD

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

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia Maryland LLC PastSince Jul 10, 2022 Accepting new patients
Medstar Health Anesthesia Services C, LLC Past Accepting new patients
Harborview Anesthesia Associates-Allan M Birenberg M.D. P.a. Past Accepting new patients
Providence Health Services, Inc Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1386644052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1337",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873051337",
            "telephone_number": "505-722-1000",
            "fax_number": "505-722-1421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 EAST NIZHONI BLVD.",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873011337",
            "telephone_number": "505-722-1000",
            "fax_number": "505-722-1421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "DOROTHY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-26",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "R067660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "401790100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; 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.