Stanley Wayne Whitaker, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

8788 Issued in NH

Practice address

24 Pleasant St
Conway, NH 03818

Phone

(603) 447-3313

Fax

(603) 447-4310

NPI assigned

Jul 14, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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 and National Provider Directory roles.

• Shelin Agrawal and Hyer PLLC

  • Diagnostic Radiology Physician
  • Las Vegas, NV
  • NPI 1861783961

  AZ

  Medicare reassignment NPD
• Ellis Bandt Birkin Kollins & Wong PLLC

  • Diagnostic Radiology Physician
  • Las Vegas, NV
  • NPI 1578584678

  AZ

  Medicare reassignment
• Southwest Medical Associates, Inc

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1659346005
  Medicare reassignment
• Timberline Radiology PA

  • Diagnostic Radiology Physician
  • Conway, NH
  • NPI 1477544807
  NPD (past)
• Southwest Medical Associates Inc.

  • Ambulatory Surgical Clinic/Center
  • Las Vegas, NV
  • NPI 1174607303
  NPD (past)

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

{
    "created_epoch": "1121299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242086400000",
    "number": "1487653267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2048",
            "city": "CONWAY",
            "state": "NH",
            "postal_code": "038182048",
            "telephone_number": "603-447-3313",
            "fax_number": "603-447-4310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 PLEASANT ST",
            "city": "CONWAY",
            "state": "NH",
            "postal_code": "03818",
            "telephone_number": "603-447-3313",
            "fax_number": "603-447-4310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "STANLEY",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-14",
        "last_updated": "2009-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NH",
            "license": "8788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TIMBERLINE TAX ID",
            "identifier": "200597587",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUND MED IMAGING TAX ID",
            "identifier": "593763829",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brent Jeffrey Underkoffler, PT
• Joseph Vaughan III
• Michael Vaughan
• Jennifer Leigh Verrill, A.T.C.
• Sarah Whelley, ARNP
• White Mountain Community Health Center
• Erin White, CRSW
• Nicholas William White, DA, LCSW, MLADC
• Benjamin Wiggin
• Kristin Wiley

• Diagnostic Radiology Physician in Conway, NH
• Providers in Conway, NH by specialty
• Diagnostic Radiology Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; 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.