Individual provider Active NPI

Karl Whiting, DO

  • Optometrist
  • Mobile, AL
National Provider Identifier
1417919648
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3A90TA658 Issued in AL
Practice address
601 E I65 Service Rd S
Mobile, AL 36606-3901
Phone
(251) 479-4458
Fax
(251) 479-4824
NPI assigned
Apr 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X S-A90-TA-658 AL
Optometrist 152W00000X 3A90TA658 AL Primary

Addresses

Primary practice location

601 E I65 Service Rd S
Mobile, AL 36606-3901

Mailing address

PO Box 850531
Mobile, AL 36685-0531
Phone (251) 479-4458

Other identifiers 4

IdentifierTypeStateIssuer
631400152MedicaidAL
51524367OtherALBCBS PROVIDER NUMBER
051524367OtherALMEDICARE PROVIDER NUMBER
631409152MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041025000742 AL Practitioner - Optometry 9133180904 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3A90TA658ALMDOptometrist
S-A90-TA-658ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Whiting Eye Care, LLC Optometrist CurrentSince Jan 29, 2023 Accepting new patients
Franklin Primary Health Center Inc. Optometrist Current Accepting new patients
Franklin Primary Health Center, Inc CurrentSince Jul 1, 2004 Accepting new patients
Franklin Primary Health Center, Inc CurrentSince Jul 1, 2004 Accepting new patients

Locations

301 Saint Joseph St
Mobile, AL 36602
Phone (251) 433-7717

601 E I65 Service Rd S
Mobile, AL 36606
Phone (251) 479-4458

1303 Dr Martin L King Jr Ave
Mobile, AL 36603
Phone (251) 436-7646

1303 Dr Martin L King Jr Ave
#A
Mobile, AL 36603

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1417919648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850531",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366850531",
            "telephone_number": "251-479-4458",
            "fax_number": "251-479-4824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E I65 SERVICE RD S",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366063901",
            "telephone_number": "251-479-4458",
            "fax_number": "251-479-4824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITING",
        "first_name": "KARL",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "S-A90-TA-658",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "3A90TA658",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "631400152",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "51524367",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER NUMBER",
            "identifier": "051524367",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "631409152",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.