Susan Whitely, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25229 Issued in AZ

Practice address

1835 W Missouri Ave
Phoenix, AZ 85015-3046

Phone

(602) 230-0777

NPI assigned

Apr 19, 2006

Last updated

May 17, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Healthy Outlook Family Medicine, PC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1023161825
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621209600000",
    "number": "1427013762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 W MISSOURI AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850153046",
            "telephone_number": "602-230-0777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 W MISSOURI AVE",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850153046",
            "telephone_number": "602-230-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITELY",
        "first_name": "SUSAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "25229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "Z61593",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nichelle Elise Whitehead, MD
• Taylor Whitehead, BT
• William George Whitehead III, PHARM.D.
• Justin David Whitehouse, M.A., ATC
• Meredith Whitehouse, ED.S.
• Dustin L Whiteman, PHARMD
• Theda Ray Whiterock-Bedoni, RN
• Carol Whitescarver, LCSW
• Betsy Ann Whitesel, A.N.P.
• Nicolette Whiteside

• Family Medicine Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.