Individual provider Active NPI

Michael N Whisenant, MD

  • Cardiovascular Disease Physician
  • Lewiston, ID
National Provider Identifier
1508813106
Registry record updated Oct 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
M-9628 Issued in ID
Practice address
2315 8TH St Grade
Lewiston, ID 83501-7301
Phone
(208) 746-1383
Fax
(208) 298-0727
NPI assigned
May 28, 2006
Last updated
Oct 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X M-9628 ID Primary

Addresses

Primary practice location

2315 8TH St Grade
Lewiston, ID 83501-7301

Mailing address

122 W 7TH Ave
450
Spokane, WA 99204-2349
Phone (509) 455-8820

Other identifiers 3

IdentifierTypeStateIssuer
P00316149OtherWARRB
807466400MedicaidID
8454886MedicaidWA

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

State licenses

LicenseStateTypeSpecialty
10455SCMDProfessional Counselor
M-9628IDMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Oconee Medical Center Past Accepting new patients
Wa Spok DH Crna LLC Cardiovascular Disease Past Accepting new patients
Providence Health & Services-Wa Past Accepting new patients
McDowell Internal Medicine, PA Cardiovascular Disease Past Accepting new patients

Organizations & group practices 4

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": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1508813106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 W 7TH AVE",
            "address_2": "450",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042349",
            "telephone_number": "509-455-8820",
            "fax_number": "509-838-4978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 8TH ST GRADE",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "835017301",
            "telephone_number": "208-746-1383",
            "fax_number": "208-298-0727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHISENANT",
        "first_name": "MICHAEL",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-28",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "ID",
            "license": "M-9628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRB",
            "identifier": "P00316149",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807466400",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8454886",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.