Individual provider Active NPI

Gregory M Whisman, MD

  • Family Medicine Physician
  • Powell, OH
National Provider Identifier
1669667598
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.089537 Issued in OH
Practice address
28 Hidden Ravines Drive
Powell, OH 43065-8736
Phone
(740) 549-7450
Fax
(740) 549-7454
NPI assigned
Sep 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35089537 OH
Family Medicine Physician 207Q00000X 35.089537 OH Primary

Addresses

Primary practice location

28 Hidden Ravines Drive
Powell, OH 43065-8736

Mailing address

L-3401
Columbus, OH 43260-3401
Phone (740) 615-1324

Other identifiers 1

IdentifierTypeStateIssuer
2781164MedicaidOH

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.089537OHMDFamily Medicine Physician
35089537OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associates in Inpatient Medicine, Inc. Past Accepting new patients
Mount Carmel Health Family Medicine Past Accepting new patients

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": "1189641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1669667598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "L-3401",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432603401",
            "telephone_number": "740-615-1324",
            "fax_number": "740-615-1344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 HIDDEN RAVINES DRIVE",
            "city": "POWELL",
            "state": "OH",
            "postal_code": "430658736",
            "telephone_number": "740-549-7450",
            "fax_number": "740-549-7454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHISMAN",
        "first_name": "GREGORY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-13",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35089537",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.089537",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2781164",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Powell, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.