Active NPI
Whitaker National Corporation
- Emergency Medicine Physician
- Louisa, KY
National Provider Identifier
1528049541
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- Legal business name
- WHITAKER NATIONAL CORPORATION
- Practice address
- Three Rivers Medical Center
2483 Highway 644
Louisa, KY 41230 - Phone
- (606) 638-9451
- NPI assigned
- Nov 8, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer Moore
- Title
- Cfo
- Phone
- (415) 435-4591
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | Primary | ||
| Nurse Practitioner | 363L00000X |
Addresses
Primary practice location
Three Rivers Medical Center
2483 Highway 644
Louisa, KY 41230
Mailing address
PO Box 936434
Atlanta, GA 31193-6434
Phone (800) 377-8721
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CA8135 | Other | RR MEDICARE | |
| 2065714 | Medicaid | OH | |
| 65921785 | Medicaid | KY | |
| 000000061861 | Other | KY | BCBS GROUP # |
| 7100009960 | Medicaid | KY | |
| 0008085000 | Medicaid | WV |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131408000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1530144000000",
"number": "1528049541",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 936434",
"city": "ATLANTA",
"state": "GA",
"postal_code": "311936434",
"telephone_number": "800-377-8721",
"fax_number": "304-697-1155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "THREE RIVERS MEDICAL CENTER",
"address_2": "2483 HIGHWAY 644",
"city": "LOUISA",
"state": "KY",
"postal_code": "41230",
"telephone_number": "606-638-9451"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WHITAKER NATIONAL CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2005-11-08",
"last_updated": "2018-06-28",
"status": "A",
"authorized_official_last_name": "MOORE",
"authorized_official_first_name": "JENNIFER",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "415-435-4591"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Emergency Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "CA8135",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2065714",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "65921785",
"state": "KY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS GROUP #",
"identifier": "000000061861",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100009960",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0008085000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Louisa, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.