Ian Eric Whittall, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MT227241 Issued in PA

Practice address

3401 N Broad St
Philadelphia, PA 19140-5103

Phone

(203) 584-1576

NPI assigned

Jun 17, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1655424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1619608031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 FRANKFORD AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191253204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191405103",
            "telephone_number": "203-584-1576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTALL",
        "first_name": "IAN",
        "middle_name": "ERIC",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-17",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT227241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Ian.Whittall@tuhs.temple.edu",
            "affiliation": "Y",
            "affiliationName": "Temple University Hospital, Inc",
            "address_1": "3401 N Broad St",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191405103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly Whitney, MD
• Theodore R Whitney Jr., M.D.
• Sylvia Whitridge, CRNP
• Camille Whitsett, M.ED.
• Erin Teresa Whittaker
• Gregory Baker Whittemore
• Joseph Anthony Whitten, MD
• James Whittenburg
• Jabar Whittier, M.D.
• Nicole Whittington, PA-C

• Surgery Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; 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.

Verify at the official NPI Registry.