Individual provider Active NPI

Lee Carl Whitaker, MD

  • Adult Medicine Physician
  • St Thomas, VI
National Provider Identifier
1508809625
Registry record updated May 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
1625 Issued in VI
Practice address
1901 9TH Street
St Thomas, VI 00802-0000
Phone
(340) 777-1996
NPI assigned
Jun 14, 2006
Last updated
May 9, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD000035229 TN
Adult Medicine Physician 207QA0505X 1625 VI Primary

Addresses

Primary practice location

1901 9TH Street
St Thomas, VI 00802-0000

Mailing address

PO Box 7425
St Thomas, VI 00801-0425
Phone (340) 777-1996

Other identifiers 2

IdentifierTypeStateIssuer
1508809625OtherTNNPI
009911897MedicaidAL

Other names 1

  • Dr. Lee C Whitaker Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, VI2 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.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091026000411 AL Practitioner - Family Practice 4688776669 Reassigns benefits to 1 organization
I20190122001811 VI Practitioner - Family Practice 4688776669 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD000035229TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Department of Health Govt of the Virgin Islands CurrentSince Aug 26, 2018 Accepting new patients
Department of Health Govt of the Virgin Islands Current Accepting new patients
Signify Health, LLC CurrentSince Jun 10, 2021 Accepting new patients
Crossroads Urgent Care PLLC Family Medicine Past Accepting new patients
The Whitaker Health Center Family Medicine Past Accepting new patients

Locations

4000 Eagle Point Corporate Dr
Birmingham, AL 35242
Phone (205) 538-0244

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

3500 Estate Richmond
St Croix, VI 00820
Phone (340) 718-1311

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336521600000",
    "number": "1508809625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7425",
            "city": "ST THOMAS",
            "state": "VI",
            "postal_code": "008010425",
            "telephone_number": "340-777-1996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 9TH STREET",
            "city": "ST THOMAS",
            "state": "VI",
            "postal_code": "008020000",
            "telephone_number": "340-777-1996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "LEE",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2012-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD000035229",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "VI",
            "license": "1625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1508809625",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009911897",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEE",
            "last_name": "WHITAKER",
            "middle_name": "C",
            "prefix": "DR.",
            "credential": "MD, MPH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in St Thomas, VI

Sources for this page

Verify at the official NPI Registry.