Individual provider Active NPI

Charles Whetsell, PH.D.

  • Psychologist
  • Irondale, AL
National Provider Identifier
1518183540
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
817 Issued in AL
Practice address
5748 Annanadale LN
Irondale, AL 35210-3401
Phone
(205) 901-6438
Fax
(205) 314-7620
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 817 AL Primary

Addresses

Primary practice location

5748 Annanadale LN
Irondale, AL 35210-3401

Mailing address

5748 Annanadale LN
Irondale, AL 35210-3401
Phone (205) 901-6438

Other identifiers 1

IdentifierTypeStateIssuer
515-76172OtherALBCBS OF AL #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190211002946 AL Practitioner - Clinical Psychologist 4183962533 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
817ALMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Matters, P.C. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739404800000",
    "number": "1518183540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5748 ANNANADALE LN",
            "city": "IRONDALE",
            "state": "AL",
            "postal_code": "352103401",
            "telephone_number": "205-901-6438",
            "fax_number": "205-314-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5748 ANNANADALE LN",
            "city": "IRONDALE",
            "state": "AL",
            "postal_code": "352103401",
            "telephone_number": "205-901-6438",
            "fax_number": "205-314-7620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHETSELL",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "AL",
            "license": "817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL #",
            "identifier": "515-76172",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Irondale, AL

Sources for this page

Verify at the official NPI Registry.