Individual provider Active NPI

Thomas M. Whiteneck, D.O.

  • Family Medicine Physician
  • Lawrenceville, GA
National Provider Identifier
1598879116
Registry record updated May 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
034077 Issued in GA
Practice address
1730 Lawrenceville Suwanee Rd
Lawrenceville, GA 30043-3507
Phone
(770) 338-0089
Fax
(770) 338-0091
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 034077 GA Primary

Addresses

Primary practice location

1730 Lawrenceville Suwanee Rd
Lawrenceville, GA 30043-3507

Mailing address

1730 Lawrenceville Suwanee Rd
Lawrenceville, GA 30043-3507
Phone (770) 338-0089

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090121000215 GA Practitioner - Family Practice 9234293127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lawrenceville Family PracticeGroup PAC ID 6406752799, 2 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians

Practice addresses (Care Compare)

1730 Lawrenceville Rd
Lawrenceville, GA 30043
Phone (770) 338-0089

2600 Compass Rd
Glenview, IL 60026-8001

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrenceville Family Practice CurrentSince Jul 26, 2010 Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients

Locations

1730 Lawrenceville Suwanee Rd
Lawrenceville, GA 30043
Phone 7703380089 ext. 241

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DABBDD

Organizations & group practices 6

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305676800000",
    "number": "1598879116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1730 LAWRENCEVILLE SUWANEE RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300433507",
            "telephone_number": "770-338-0089",
            "fax_number": "770-338-0091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1730 LAWRENCEVILLE SUWANEE RD",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300433507",
            "telephone_number": "770-338-0089",
            "fax_number": "770-338-0091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITENECK",
        "first_name": "THOMAS",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2011-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "034077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.