Active NPI
Emmett E Whitaker III, MD
- Pain Medicine (Anesthesiology) Physician
- Burlington, VT
National Provider Identifier
1609916311
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Medicine (Anesthesiology) Physician
- License
- D73475
- Practice address
- 111 Colchester Ave
Burlington, VT 05401-1473 - Phone
- (802) 847-2415
- NPI assigned
- Feb 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 042.0013903 | VT | |
| Anesthesiology Physician | 207L00000X | D73475 | MD | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 35.121452 | OH | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | D73475 | MD | Primary |
Addresses
Primary practice location
111 Colchester Ave
Burlington, VT 05401-1473
Mailing address
700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-4200
Other practice location 1
600 N Wolfe St
Baltimore, MD 21287-0005
Phone (410) 933-4853
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0094956 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D73475 | MD | MD | Pain Medicine (Anesthesiology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Johns Hopkins University | Pain Medicine | Current | Accepting new patients |
| Johns Hopkins University | Current | Accepting new patients |
Locations
600 N Wolfe St
Baltimore, MD 21287
6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704
Organizations & group practices 2
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.
-
- Pain Medicine (Anesthesiology) Physician
- Baltimore, MD
- NPI 1922008549
-
- Ophthalmology Physician
- Belcamp, MD
- NPI 1376342774
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698278400000",
"number": "1609916311",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 CHILDRENS DR",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432052664",
"telephone_number": "614-722-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 COLCHESTER AVE",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054011473",
"telephone_number": "802-847-2415"
}
],
"practiceLocations": [
{
"address_1": "600 N Wolfe St",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212870005",
"country_code": "US",
"telephone_number": "410-933-4853",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WHITAKER",
"first_name": "EMMETT",
"middle_name": "E",
"name_prefix": "Dr.",
"name_suffix": "III",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-08",
"last_updated": "2023-10-26",
"certification_date": "2023-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "VT",
"license": "042.0013903",
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MD",
"license": "D73475",
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "OH",
"license": "35.121452",
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "MD",
"license": "D73475",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0094956",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Burlington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2023; 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.