NPIMap

Individual provider Active NPI

Joshua Allan Whatley, MD

  • Family Medicine Physician
  • Lake Charles, LA
National Provider Identifier
1386961787
Registry record updated Jun 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.204810 Issued in LA
Practice address
4345 Nelson Rd Ste 102
Lake Charles, LA 70605-4183
Phone
(337) 480-7900
Fax
(337) 602-6358
NPI assigned
Apr 23, 2010
Last updated
Jun 9, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD.204810 LA Primary

Addresses

Primary practice location

4345 Nelson Rd Ste 102
Lake Charles, LA 70605-4183

Mailing address

P O Box 123594
Dept 3594
Dallas, TX 75312-3594
Phone (337) 494-2921

Other identifiers 2

IdentifierTypeStateIssuer
2107747MedicaidLA
MD.204810OtherLASTATE MEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20110912000697 LA Practitioner - Family PracticePractitioner - Emergency Medicine 6406027051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Louisiana State University School of Medicine in New Orleans, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MMG Nelson Rd LLCGroup PAC ID 9032407663, 5 clinicians

Practice addresses (Care Compare)

4345 Nelson Rd
Suite 102
Lake Charles, LA 70605-4183
Phone (337) 480-7900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
MMG Nelson Rd LLC CurrentSince Jul 1, 2017 Accepting new patients
Diversified Health Care-Lake Charles, LLC Past Accepting new patients
Emergency Medicine Specialist, Apmc Past Accepting new patients

Locations

4345 Nelson Rd
Ste 102
Lake Charles, LA 70605
Phone (337) 439-2020

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

Hospital & facility affiliations 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1271980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1386961787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 123594",
            "address_2": "DEPT 3594",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753123594",
            "telephone_number": "337-494-2921",
            "fax_number": "337-494-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4345 NELSON RD STE 102",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054183",
            "telephone_number": "337-480-7900",
            "fax_number": "337-602-6358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHATLEY",
        "first_name": "JOSHUA",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-23",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD.204810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2107747",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "MD.204810",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.