Individual provider Active NPI

Keith Garrett Whitlock, MD

  • Orthopaedic Trauma Physician
  • Raleigh, NC
National Provider Identifier
1396241279
Registry record updated Sep 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Trauma PhysicianTaxonomy code 207XX0801X
License
2024-00594 Issued in NC
Practice address
3009 New Bern Ave
Raleigh, NC 27610-1214
Phone
(630) 200-2738
NPI assigned
Apr 1, 2018
Last updated
Sep 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2024-00594 NC
Orthopaedic Trauma Physician 207XX0801X 2024-00594 NC Primary

Addresses

Primary practice location

3009 New Bern Ave
Raleigh, NC 27610-1214

Mailing address

2319 Wilmington CT
Naperville, IL 60565-5382
Phone (630) 200-2738

Other identifiers 1

IdentifierTypeStateIssuer
2024-00594MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240826000756 NC Practitioner - Orthopedic Surgery 5496101263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wakemed Specialists Group LLCGroup PAC ID 2466788377, 868 clinicians

Practice addresses (Care Compare)

3009 New Bern Ave
Raleigh, NC 27610-1214
Phone (919) 232-5020

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wakemed Specialists Group LLC CurrentSince Sep 9, 2024 Accepting new patients
Wakemed Specialists Group LLC Orthopaedic Surgery CurrentSince Sep 9, 2024 Accepting new patients
Wakemed Specialists Group, LLC Orthopaedic Surgery Current Accepting new patients

Locations

120 Healthplex Way
Apex, NC 27502
Phone (919) 350-0550

110 Kildaire Park Dr
Cary, NC 27518
Phone (919) 235-0616

2400 N Main St
Fuquay Varina, NC 27526
Phone (919) 232-0322

400 US 70 Hwy E
Garner, NC 27529
Phone (919) 235-6400

10010 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1380

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

3009 New Bern Ave
Raleigh, NC 27610
Phone (919) 232-5021

3024 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-5318

8001 T W Alexander Dr
Raleigh, NC 27617
Phone (919) 350-0953

1030 Siena Dr
Wake Forest, NC 27587
Phone (919) 235-6511

Interoperability endpoints

  • Direct secure messaging: kwhitlock561255@directhisp.wakemed.org

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 3

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": "1522540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726704000000",
    "number": "1396241279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2319 WILMINGTON CT",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605655382",
            "telephone_number": "630-200-2738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 NEW BERN AVE",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276101214",
            "telephone_number": "630-200-2738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLOCK",
        "first_name": "KEITH",
        "middle_name": "GARRETT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-01",
        "last_updated": "2024-09-19",
        "certification_date": "2024-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "2024-00594",
            "primary": false
        },
        {
            "code": "207XX0801X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Trauma",
            "state": "NC",
            "license": "2024-00594",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2024-00594",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.