Active NPI
Kenneth Clifford Whithaus, M.D.
- Anatomic Pathology & Clinical Pathology Physician
- Tallahassee, FL
National Provider Identifier
1619060787
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- MD.29340
- Practice address
- 1899 Eider CT
Tallahassee, FL 32308-4537 - Phone
- (850) 219-7640
- NPI assigned
- Oct 2, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | R9321 | AL | |
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | MD.29340 | AL | Primary |
Addresses
Primary practice location
1899 Eider CT
Tallahassee, FL 32308-4537
Mailing address
1899 Eider Court
Tallahassee, FL 32308-4537
Phone (850) 219-7640
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ME 109950 | Other | FL | ME LICENCE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Pathology
- Education
- University of South Florida College of Medicine, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1899 Eider CT
Tallahassee, FL 32308-4537
Phone (850) 878-5143
Hospital & facility affiliations
- Tallahassee Memorial Healthcare
- Jackson Hospital
- Doctors Memorial Hospital Inc
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD.29340 | AL | MD | Anatomic Pathology & Clinical Pathology Physician |
| R9321 | AL | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ketchum Wood & Burgert Chartered DRS Ketchum Wood & Burgert | Current | Accepting new patients | |
| Ketchum Wood & Burgert Chartered DRS Ketchum Wood & Burgert | Anatomic Pathology & Clinical Pathology | Current | Accepting new patients |
Locations
1899 Eider Ct
Tallahassee, FL 32308
Phone (850) 878-5143
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.
-
- Anatomic Pathology & Clinical Pathology Physician
- Tallahassee, FL
- NPI 1821060898
-
- Clinical Medical Laboratory
- Tallahassee, FL
- NPI 1558335869
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Perry, FL
- NPI 1427092006
-
- General Acute Care Hospital
- Marianna, FL
- NPI 1538108725
-
- General Acute Care Hospital
- Tallahassee, FL
- NPI 1437177664
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159747200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307318400000",
"number": "1619060787",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1899 EIDER COURT",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323084537",
"telephone_number": "850-219-7640"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1899 EIDER CT",
"city": "TALLAHASSEE",
"state": "FL",
"postal_code": "323084537",
"telephone_number": "850-219-7640"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITHAUS",
"first_name": "KENNETH",
"middle_name": "CLIFFORD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-02",
"last_updated": "2011-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "AL",
"license": "R9321",
"primary": false
},
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "AL",
"license": "MD.29340",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ME LICENCE NUMBER",
"identifier": "ME 109950",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tallahassee, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.