Active NPI
Brianna Elys Whithorn, DO
- Vascular Surgery Physician
- Saint Louis, MO
National Provider Identifier
1568923332
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 02009123A
- Practice address
- 1402 S Grand Blvd RM M260
Saint Louis, MO 63104-1004 - Phone
- (314) 577-8317
- Fax
- (314) 268-5466
- NPI assigned
- Mar 26, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 02009123A | IN | Primary |
Addresses
Primary practice location
1402 S Grand Blvd RM M260
Saint Louis, MO 63104-1004
Mailing address
520 Mary St Ste 520
Evansville, IN 47710-1682
Phone (812) 424-8231
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- bwhithorn551138@directhoustonmethodist.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1568923332",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "520 MARY ST STE 520",
"city": "EVANSVILLE",
"state": "IN",
"postal_code": "477101682",
"telephone_number": "812-424-8231"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1402 S GRAND BLVD RM M260",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041004",
"telephone_number": "314-577-8317",
"fax_number": "314-268-5466"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITHORN",
"first_name": "BRIANNA",
"middle_name": "ELYS",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-26",
"last_updated": "2026-07-13",
"certification_date": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "IN",
"license": "02009123A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.