NPIMap

Organization Active NPI

Whitney Sleep Diagnostics & Consultants, LLC

  • Clinic/Center
  • Detroit Lakes, MN
National Provider Identifier
1396985073
Registry record updated Feb 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
39456 Issued in MN
Legal business name
WHITNEY SLEEP DIAGNOSTICS & CONSULTANTS, LLC
Practice address
712 Washington Ave
Detroit Lakes, MN 56501-3012
Phone
(218) 844-6150
Fax
(763) 201-5545
NPI assigned
Feb 20, 2009
Last updated
Feb 21, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2013

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

Authorized official

Name
Dr. Courtney Wade Whitney, D.O.NPI 1861461329
Title
Physician/President
Phone
(218) 844-6150

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 39456 MN Primary

Addresses

Primary practice location

712 Washington Ave
Detroit Lakes, MN 56501-3012

Mailing address

119 Graystone PLZ
Suite 102
Detroit Lakes, MN 56501-3034
Phone (218) 844-6150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090716000111 MN Part B Supplier - Clinic/Group Practice 8022160431 Receives reassigned benefits from 4 practitioners
Practice locations: Detroit Lakes, MN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Whitney Sleep Diagnostics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

119 Graystone Plz
Ste 102
Detroit Lakes, MN 56501
Phone (218) 844-6150

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1235088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361404800000",
    "number": "1396985073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 GRAYSTONE PLZ",
            "address_2": "SUITE 102",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013034",
            "telephone_number": "218-844-6150",
            "fax_number": "763-201-5545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 WASHINGTON AVE",
            "city": "DETROIT LAKES",
            "state": "MN",
            "postal_code": "565013012",
            "telephone_number": "218-844-6150",
            "fax_number": "763-201-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITNEY SLEEP DIAGNOSTICS & CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-20",
        "last_updated": "2013-02-21",
        "status": "A",
        "authorized_official_last_name": "WHITNEY",
        "authorized_official_first_name": "COURTNEY",
        "authorized_official_middle_name": "WADE",
        "authorized_official_title_or_position": "PHYSICIAN/PRESIDENT",
        "authorized_official_telephone_number": "218-844-6150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MN",
            "license": "39456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit Lakes, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.