Individual provider Active NPI

Brian Lee Whited, MD

  • Family Medicine Physician
  • Cannon Falls, MN
National Provider Identifier
1457312662
Registry record updated Nov 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35878 Issued in MN
Practice address
1116 Mill St W
Cannon Falls, MN 55009-1824
Phone
(507) 293-3951
NPI assigned
Mar 29, 2006
Last updated
Nov 15, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35878 MN Primary

Addresses

Primary practice location

1116 Mill St W
Cannon Falls, MN 55009-1824

Mailing address

1116 Mill St W
Cannon Falls, MN 55009-1824
Phone (507) 263-3951

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20240904004830 NM Practitioner - Family Practice 3274434139 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

465 Saint Michaels Dr
Suite 230
Santa Fe, NM 87505-8602
Phone (505) 913-4710

5501 Herrera Dr
Santa Fe, NM 87507-2684

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Hospital Family Medicine CurrentSince Sep 23, 2024 Accepting new patients
St. Vincent Hospital CurrentSince Sep 23, 2024 Accepting new patients
St Vincent Hospital Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Past Accepting new patients

Locations

455 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-3361

465 Saint Michaels Dr
Ste 200
Santa Fe, NM 87505
Phone (505) 995-4901

5501 Herrera Dr
Santa Fe, NM 87507
Phone (505) 913-3233

Interoperability endpoints

  • Direct secure messaging: bwhited399803@christushealth.direct-ci.net
  • Direct secure messaging: bwhited44114@ehrdirect.mayoclinicmsg.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1457312662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1116 MILL ST W",
            "city": "CANNON FALLS",
            "state": "MN",
            "postal_code": "550091824",
            "telephone_number": "507-263-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1116 MILL ST W",
            "city": "CANNON FALLS",
            "state": "MN",
            "postal_code": "550091824",
            "telephone_number": "507-293-3951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITED",
        "first_name": "BRIAN",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-29",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "35878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cannon Falls, MN

Sources for this page

Verify at the official NPI Registry.