Individual provider Active NPI

Trevor W Whitmore, PA-C

  • Physician Assistant
  • Gilbert, AZ
National Provider Identifier
1649238783
Registry record updated Jan 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2399 Issued in AZ
Practice address
1425 S Higley Rd
Suite 102
Gilbert, AZ 85296-4798
Phone
(480) 988-6878
Fax
(480) 988-6879
NPI assigned
May 1, 2006
Last updated
Jan 11, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2399 AZ Primary

Addresses

Primary practice location

1425 S Higley Rd
Suite 102
Gilbert, AZ 85296-4798

Mailing address

1425 S Higley Rd
Suite 102
Gilbert, AZ 85296-4798
Phone (480) 988-6878

Other identifiers 1

IdentifierTypeStateIssuer
560674MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051012000470 AZ Practitioner - Physician Assistant 0547285165 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
James Nichols MD LTDGroup PAC ID 1759474455, 5 clinicians

Practice addresses (Care Compare)

13838 S 46TH PL
Suite 320
Phoenix, AZ 85044-7804
Phone (480) 759-5151

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medical Solutions, LTD. Past Accepting new patients
Jill E Kerr, D. O. P.C. Past Accepting new patients
Mountain View Family Practice Past Accepting new patients
Sundance Medical Associates PLLC PastSince Jun 1, 2005 Accepting new patients

Organizations & group practices 7

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": "1146441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200009600000",
    "number": "1649238783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 S HIGLEY RD",
            "address_2": "SUITE 102",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852964798",
            "telephone_number": "480-988-6878",
            "fax_number": "480-988-6879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 S HIGLEY RD",
            "address_2": "SUITE 102",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852964798",
            "telephone_number": "480-988-6878",
            "fax_number": "480-988-6879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITMORE",
        "first_name": "TREVOR",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-01",
        "last_updated": "2008-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "560674",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.