Kevin M Whitman

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

MD-STUDENT Issued in NY

Practice address

75 Barrett Dr Unit 115
Webster, NY 14580-7005

Phone

(585) 456-8394

Fax

(585) 299-9825

NPI assigned

Dec 23, 2016

Reactivated

Dec 22, 2021

Last updated

Oct 2, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1482451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1578008793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 BARRETT DR UNIT 115",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145807005",
            "telephone_number": "585-456-8394",
            "fax_number": "585-299-9825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 BARRETT DR UNIT 115",
            "city": "WEBSTER",
            "state": "NY",
            "postal_code": "145807005",
            "telephone_number": "585-456-8394",
            "fax_number": "585-299-9825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITMAN",
        "first_name": "KEVIN",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-23",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "deactivation_date": "2021-08-26",
        "reactivation_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "MD-STUDENT",
            "primary": true
        },
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "NY",
            "license": "447603",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Todd A Wendel, O.D.
• Christine A Wesley, RN
• Sherry Lynn Whaley, LPN
• Carolyn Sue Wheeler, LMT
• Amy Whitenack, RPH
• Susan E Wickum
• Wiktorski Orthodontics PLLC
• William E Zugner, D.D.S., Todd R. Pedersen, D.D.S.
• James M Williams
• Latavia Simone Wilson-Jarrett, RN

• Student in an Organized Health Care Education/Training Program in Webster, NY
• Providers in Webster, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.