Connor Whitaker, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD481657 Issued in PA

Practice address

2101 W Lehigh Ave Ste a
Philadelphia, PA 19132-2664

Phone

(267) 866-7211

Fax

(267) 546-4064

NPI assigned

Mar 27, 2020

Last updated

Jul 6, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

State licenses

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.

• Dedicated Pennsylvania Holding, LLC

  dba Dedicated Pennsylvania Mayfair

  • Specialist
  • Philadelphia, PA
  • NPI 1477053569
  Medicare reassignment NPD
• Dedicated Pennsylvania Holding, LLC

  • Specialist
  • Philadelphia, PA
  • NPI 1366950776
  NPD
• Dedicated Pennsylvania Holding, LLC

  • Specialist
  • Philadelphia, PA
  • NPI 1841707965

  Family Medicine

  NPD
• Dedicated Pennsylvania Holding, LLC

  • Internal Medicine Physician
  • Philadelphia, PA
  • NPI 1952804312
  NPD (past)
• Encompass Remote Inc

  • Physiological Laboratory
  • Canonsburg, PA
  • NPI 1063105559
  NPD (past)

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

{
    "created_epoch": "1585267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1427686344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 W LEHIGH AVE STE A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191322664",
            "telephone_number": "267-866-7211",
            "fax_number": "267-546-4064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 W LEHIGH AVE STE A",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191322664",
            "telephone_number": "267-866-7211",
            "fax_number": "267-546-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "CONNOR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-27",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD481657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Whetstone, LCSW
• Whidbey Island Public Hospital District
• Elizabeth Whidden, MD
• Matthew Richardson Whipple, RDN, LDN
• Cache Whitaker
• Diamond Whitaker
• Kathryn Whitaker, M.D.
• Kristen Danielle Whitaker
• William Whitaker, AAS, BA, M.ED.
• Caroline Whitcomb, CRNP

• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.