NPIMap

Organization Active NPI

Whitaker National Corporation

  • Emergency Medicine Physician
  • Paintsville, KY
National Provider Identifier
1407846835
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
WHITAKER NATIONAL CORPORATION
Practice address
625 James Trimble Blvd
Paintsville, KY 41240
Phone
(606) 789-3511
Fax
(606) 789-1432
NPI assigned
Oct 26, 2005
Last updated
Jun 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Authorized official

Name
Jennifer Moore
Title
Cfo
Phone
(415) 435-4591

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X NU Primary
Physician Assistant 363A00000X NU

Addresses

Primary practice location

625 James Trimble Blvd
Paintsville, KY 41240

Mailing address

PO Box 936434
Atlanta, GA 31193-6434
Phone (800) 377-8721

Other identifiers 5

IdentifierTypeStateIssuer
2502198MedicaidOH
000000061861OtherKYBCBS GROUP #
0008085000MedicaidWV
65932204MedicaidKY
CA8135OtherRR MEDICARE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530144000000",
    "number": "1407846835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 936434",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311936434",
            "telephone_number": "800-377-8721",
            "fax_number": "304-697-1155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 JAMES TRIMBLE BLVD",
            "city": "PAINTSVILLE",
            "state": "KY",
            "postal_code": "41240",
            "telephone_number": "606-789-3511",
            "fax_number": "606-789-1432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITAKER NATIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-26",
        "last_updated": "2018-06-28",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "415-435-4591"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2502198",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP #",
            "identifier": "000000061861",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0008085000",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65932204",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CA8135",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paintsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; 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.