John R Whitworth, M.D.

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

34143 Issued in TN

Practice address

806 Estate PL
Memphis, TN 38120-0600

Phone

(901) 681-4017

Fax

(901) 681-4013

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jwhitworth28012@mlh.direct-ci.com
• FHIR API: https://epicproxy.et1342.epichosted.com/APIProxyPRD/MLH/api/FHIR/R4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ut Lebonheur Pediatric Specialists, Inc.

  • Pediatrics Physician
  • Memphis, TN
  • NPI 1093024101

  Pediatric Gastroenterology

  Medicare reassignment NPD
• Memphis Pediatric Gastroenterology & Hepatology PC

  • Pediatric Gastroenterology Physician
  • Memphis, TN
  • NPI 1750455945
  NPD (past)
• Methodist Healthcare - Memphis Hospitals

  • Community/Retail Pharmacy
  • Memphis, TN
  • NPI 1225723133
  NPD (past)
• Methodist Healthcare - Memphis Hospitals

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Memphis, TN
  • NPI 1245383355
  NPD (past)
• Methodist Healthcare - Memphis Hospitals

  • Children's Hospital
  • Memphis, TN
  • NPI 1386709871
  NPD (past)

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1699707638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 UNION AVENUE EXT",
            "address_2": "SUITE 1220",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381124426",
            "telephone_number": "901-458-9785",
            "fax_number": "901-458-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "806 ESTATE PL",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381200600",
            "telephone_number": "901-681-4017",
            "fax_number": "901-681-4013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITWORTH",
        "first_name": "JOHN",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "TN",
            "license": "34143",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "98990",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02724221",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "4128673",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3387689",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSOURCE",
            "identifier": "H41886",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "19169",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4128673",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185482",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marisa Whitsett
• Anne Whitten, CRNA
• Detris Whitten, LMSW
• Eric D Whittington, B.S.
• Lauren Whittington, M.A., CCC-SLP
• Whole Health Chiropractic and Wellness Center, PLLC
• Wholly Wounds, PLLC
• Linda O. Wible, DDS
• Wallace Wicke, PHARM.D.
• Shanda Camille Wickfall

• Pediatric Gastroenterology Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Pediatric Gastroenterology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.