Active NPI
Thomas Whiteman
- Psychologist
- Paoli, PA
National Provider Identifier
1659442283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS004558L
- Practice address
- 1440 Russell Rd
Paoli, PA 19301-1236 - Phone
- (610) 644-6464
- NPI assigned
- Nov 13, 2006
- Last updated
- May 9, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS004558L | PA | Primary |
Addresses
Primary practice location
1440 Russell Rd
Paoli, PA 19301-1236
Mailing address
1440 Russell Rd
Paoli, PA 19301-1236
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0076612000 | Other | PA | IBC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS004558L | PA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Management Inc | Past | Accepting new patients |
Organizations & group practices 1
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": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210291200000",
"number": "1659442283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1440 RUSSELL RD",
"city": "PAOLI",
"state": "PA",
"postal_code": "193011236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1440 RUSSELL RD",
"city": "PAOLI",
"state": "PA",
"postal_code": "193011236",
"telephone_number": "610-644-6464"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITEMAN",
"first_name": "THOMAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2008-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS004558L",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IBC",
"identifier": "0076612000",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Paoli, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.