Individual provider Active NPI

James W Whitfield, MD

  • Nephrology Physician
  • Gallup, NM
National Provider Identifier
1639141443
Registry record updated Jan 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
89-329 Issued in NM
Practice address
1801 Redrock Dr
Gallup, NM 87301-5655
Phone
(505) 863-7993
Fax
(505) 863-9406
NPI assigned
Feb 6, 2006
Last updated
Jan 5, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 89-329 NM Primary

Addresses

Primary practice location

1801 Redrock Dr
Gallup, NM 87301-5655

Mailing address

1801 Redrock Dr
Gallup, NM 87301-5655
Phone (505) 863-7993

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110104000501 TX Practitioner - Internal MedicinePractitioner - Nephrology 3476512997 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
89-329NMMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
DHHS,PHS,Naihs, Gallup Indian Medical Center CurrentSince Jul 1, 2001 Accepting new patients
Red Rocks Dialysis, LLC PastSince Jul 1, 2008 Accepting new patients

Locations

1901 Red Rock Dr
Gallup, NM 87301
Phone (505) 726-6875

516 E Nizhoni Blvd
Gallup, NM 87301
Phone (505) 722-1326

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231113600000",
    "number": "1639141443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 REDROCK DR",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015655",
            "telephone_number": "505-863-7993",
            "fax_number": "505-863-9406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 REDROCK DR",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873015655",
            "telephone_number": "505-863-7993",
            "fax_number": "505-863-9406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITFIELD",
        "first_name": "JAMES",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2009-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "NM",
            "license": "89-329",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallup, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.