Kenneth Davis Whidden Jr., D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

CH8151 Issued in FL

Practice address

501 Harbor Blvd
Suite C
Destin, FL 32541-2348

Phone

(850) 654-1850

Fax

(850) 654-9994

NPI assigned

Oct 21, 2005

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 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Whidden, Inc.

  • Chiropractor
  • Destin, FL
  • NPI 1508137639
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295049600000",
    "number": "1700876729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 HARBOR BLVD",
            "address_2": "SUITE C",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325412348",
            "telephone_number": "850-654-1850",
            "fax_number": "850-654-9994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 HARBOR BLVD",
            "address_2": "SUITE C",
            "city": "DESTIN",
            "state": "FL",
            "postal_code": "325412348",
            "telephone_number": "850-654-1850",
            "fax_number": "850-654-9994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHIDDEN",
        "first_name": "KENNETH",
        "middle_name": "DAVIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2011-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "FL",
            "license": "CH8151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381569200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alvin F Wells, MD
• Kevin W Wells, OD
• Whidden, Inc.
• Jeremy Whidden
• Jessica Whidden, DC
• Whispering Wind Emergency Physicians, LLC
• White-Wilson Medical Center, P.a.
• Christopher J White
• Annabelle Wilcox, LDO
• William M. Escoffery

• Sports Physician Chiropractor in Destin, FL
• Providers in Destin, FL by specialty
• Sports Physician Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.