Individual provider Active NPI

Whitni Michael Richard, DO

  • Family Medicine Physician
  • Enterprise, AL
National Provider Identifier
1609385293
Registry record updated Aug 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO.2119 Issued in AL
Practice address
101 Professional LN
Enterprise, AL 36330-2085
Phone
(334) 347-3404
NPI assigned
Sep 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2020

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 DO.2119 AL Primary

Addresses

Primary practice location

101 Professional LN
Enterprise, AL 36330-2085

Mailing address

101 Professional LN
Enterprise, AL 36330-2085
Phone (334) 347-3404

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20200925001003 AL Practitioner - Family Practice 9436578317 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Houston County Healthcare AuthorityGroup PAC ID 9436062296, 256 clinicians

Practice addresses (Care Compare)

101 Professional LN
Enterprise, AL 36330-2085
Phone (334) 347-3404

Hospital & facility affiliations

  • Southeast Alabama Homecare Home health agency, Enterprise, AL, CCN 017016
  • Medical Center Enterprise Hospital, Enterprise, AL, CCN 010049

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO.2119ALMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Houston County Healthcare Authority Family Medicine Current Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Houston County Healthcare Authority Family Medicine CurrentSince Aug 26, 2020 Accepting new patients
Southeast Alabama Medical Center Employee Pharmacy Past Accepting new patients

Locations

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

101 Professional Ln
Enterprise, AL 36330
Phone (334) 347-3404

Interoperability endpoints

  • Direct secure messaging: wrichard14499@southeasthealth.direct-ci.com

Organizations & group practices 4

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": "1506384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598572800000",
    "number": "1609385293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PROFESSIONAL LN",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302085",
            "telephone_number": "334-347-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PROFESSIONAL LN",
            "city": "ENTERPRISE",
            "state": "AL",
            "postal_code": "363302085",
            "telephone_number": "334-347-3404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARD",
        "first_name": "WHITNI",
        "middle_name": "MICHAEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-26",
        "last_updated": "2020-08-28",
        "certification_date": "2020-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO.2119",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, AL

Sources for this page

Verify at the official NPI Registry.