NPIMap

Individual provider Active NPI

Jimmy Don Whetsell, PA-C

  • Physician Assistant
  • Wichita Falls, TX
National Provider Identifier
1689759524
Registry record updated Oct 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA02504 Issued in TX
Practice address
1511 10TH St
Wichita Falls, TX 76301-4430
Phone
(940) 767-0818
Fax
(940) 767-0921
NPI assigned
Oct 26, 2006
Last updated
Oct 15, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2014

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 PA02504 TX Primary

Addresses

Primary practice location

1511 10TH St
Wichita Falls, TX 76301-4430

Mailing address

1511 10TH St
Wichita Falls, TX 76301-4430
Phone (940) 767-0818

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090115000547 TX Practitioner - Physician Assistant 5092878173 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1600 11TH St
Wichita Falls, TX 76301-4388

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
United Regional Health Care System Inc Current Accepting new patients

Locations

1600 11th St
Wichita Falls, TX 76301
Phone (940) 263-3000

Interoperability endpoints

  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
  • FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/fhir/r4/
  • Direct secure messaging: jwhetsell14981@unitedregional.medalliesdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413331200000",
    "number": "1689759524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1511 10TH ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014430",
            "telephone_number": "940-767-0818",
            "fax_number": "940-767-0921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1511 10TH ST",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014430",
            "telephone_number": "940-767-0818",
            "fax_number": "940-767-0921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHETSELL",
        "first_name": "JIMMY",
        "middle_name": "DON",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2014-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

Verify at the official NPI Registry.