Individual provider Active NPI

Halana Victoria Whitehead, MD

  • Neonatal-Perinatal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1508208646
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
2016010899 Issued in MO
Practice address
1 Childrens PL
Div Ped Newborn Medicine
Saint Louis, MO 63110-1002
Phone
(314) 454-2683
Fax
(314) 454-4633
NPI assigned
Jul 17, 2013
Sex
Female
Sole proprietor
No

Organizations & group practices 9

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.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments
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.

Medicare enrollment records 2

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20190627000240 MO Practitioner - Pediatric Medicine 6800120726 Reassigns benefits to 1 organization
I20190703001100 IL Practitioner - Pediatric MedicinePractitioner - Other (Physician) 6800120726 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2016010899MOMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Jul 1, 2019 Accepting new patients
Washington University CurrentSince Jul 1, 2019 Accepting new patients
Washington University Physicians in Illinois, Inc CurrentSince Jul 1, 2019 Accepting new patients
Washington University Physicians in Illinois, Inc Current Accepting new patients
Washington University Physicians in Illinois, Inc CurrentSince Jul 1, 2019 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Barnes Jewish Hospital Past Accepting new patients
St. Louis Children'S Hospital Past Accepting new patients
Progress West Healthcare Center Past Accepting new patients

Locations

1404 Cross St
Shiloh, IL 62269
Phone (618) 607-1000

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

1 Childrens Pl
Ste C
Saint Louis, MO 63110
Phone (314) 454-2104

4240 Duncan Ave
Ste 301
Saint Louis, MO 63110

1 Childrens Pl
Saint Louis, MO 63110
Phone (314) 454-2076

1 Childrens Pl
#8116
Saint Louis, MO 63110
Phone (314) 454-6095

Interoperability endpoints

  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • Direct secure messaging: hwhitehead157163@direct.carenet.org

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2016010899 MO
Neonatal-Perinatal Medicine Physician 2080N0001X 2016010899 MO Primary

Addresses

NPPES NPI Registry

Primary practice location

1 Childrens PL
Div Ped Newborn Medicine
Saint Louis, MO 63110-1002

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 454-2683

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
200062017MedicaidMO

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 17, 2025.

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1508208646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-454-2683",
            "fax_number": "314-454-4633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHILDRENS PL",
            "address_2": "DIV PED NEWBORN MEDICINE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101002",
            "telephone_number": "314-454-2683",
            "fax_number": "314-454-4633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "HALANA",
        "middle_name": "VICTORIA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2016010899",
            "primary": false
        },
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MO",
            "license": "2016010899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200062017",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "1 Childrens Pl",
            "address_2": "Div Ped Newborn Medicine",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.