Active NPI
Walter M Whitehouse Jr., MD
- Vascular Surgery Physician
- Ypsilanti, MI
National Provider Identifier
1437195179
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 4301034157
- Practice address
- 5325 Elliott Dr
Suite 104
Ypsilanti, MI 48197-8633 - Phone
- (734) 712-8150
- Fax
- (734) 712-8151
- NPI assigned
- Jun 21, 2006
- Last updated
- Sep 19, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 4301034157 | MI | Primary |
Addresses
Primary practice location
5325 Elliott Dr
Suite 104
Ypsilanti, MI 48197-8633
Mailing address
5325 Elliott Dr
Suite 104
Ypsilanti, MI 48197-8633
Phone (734) 712-8150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4146952-10 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Noninvasive Vascular Testing Inc | Vascular Surgery | Past | Accepting new patients |
| Lima Memorial Joint Operating Company | Past | Accepting new patients | |
| Michigan Multispecialty Physicians, P.C. | Vascular Surgery | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Critical Care Medicine (Internal Medicine) Physician
- Ypsilanti, MI
- NPI 1912941337
Vascular Surgery
-
- Vascular Specialist/Technologist Cardiovascular
- Ypsilanti, MI
- NPI 1316083116
Vascular Surgery
-
dba Lima Memorial Health System
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348012800000",
"number": "1437195179",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5325 ELLIOTT DR",
"address_2": "SUITE 104",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481978633",
"telephone_number": "734-712-8150",
"fax_number": "734-712-8151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5325 ELLIOTT DR",
"address_2": "SUITE 104",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481978633",
"telephone_number": "734-712-8150",
"fax_number": "734-712-8151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITEHOUSE",
"first_name": "WALTER",
"middle_name": "M",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-21",
"last_updated": "2012-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "MI",
"license": "4301034157",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4146952-10",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ypsilanti, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.