John Whittaker MD LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D0053262 Issued in MD

Legal business name

JOHN WHITTAKER MD LLC

Doing business as

Pocomoke Primary Care

Practice address

1035 Ocean Hwy
Pocomoke City, MD 21851-3052

Phone

(410) 957-7071

Fax

(410) 297-7942

NPI assigned

Oct 4, 2007

Last updated

Dec 20, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John David Whittaker, MDNPI 1548220692

Title

Physician/Owner

Phone

(410) 957-7071

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pocomoke Primary Care Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John David Whittaker, M.D.

  • Family Medicine Physician
  • Pocomoke City, MD
  • NPI 1548220692
  Medicare reassignment Authorized official
• Dennis A Cuzzo, DC

  • Chiropractor
  • Englishtown, NJ
  • NPI 1134280936
  NPD (past)

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639958400000",
    "number": "1538357595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1035 OCEAN HWY",
            "city": "POCOMOKE CITY",
            "state": "MD",
            "postal_code": "218513052",
            "telephone_number": "443-223-3029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1035 OCEAN HWY",
            "city": "POCOMOKE CITY",
            "state": "MD",
            "postal_code": "218513052",
            "telephone_number": "410-957-7071",
            "fax_number": "410-297-7942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN WHITTAKER MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-04",
        "last_updated": "2021-12-20",
        "certification_date": "2021-12-20",
        "status": "A",
        "authorized_official_last_name": "WHITTAKER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "410-957-7071",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0053262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "016280900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pocomoke Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Micheline Costa Holmes, CRNP
• Stephanie Houck, R.N.
• Humble Providers Care
• Natosha R Jackson, RD LDN
• Shaneka Denise Jews, LMSW
• Dominique Jones
• Latasha Jones
• Stephen Nelson Jones, O.D.
• Tammy Lou Jones, LCSW-C
• Suresh Kandagatla

• Family Medicine Physician in Pocomoke City, MD
• Providers in Pocomoke City, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.