Chester C. Robert Whitley IV, P.A.-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA1517 Issued in NV

Practice address

4517 Blue Diamond Rd
Las Vegas, NV 89139-7620

Phone

(725) 258-2982

Fax

(877) 709-4341

NPI assigned

Jan 3, 2012

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 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Centerwell Senior Primary Care NV P CGroup PAC ID 5092132340, 71 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chester.whitley@centerwell.eclinicaldirectplus.com

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.

• Centerwell Senior Primary Care NV P C

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1285257667
  Medicare reassignment Care Compare group
• Intermountain Medical Holdings Nevada Inc

  • Internal Medicine Physician
  • Henderson, NV
  • NPI 1245997279
  Medicare reassignment
• Centerwell Senior Primary Care (NV) PC

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1053029488
  NPD
• Centerwell Senior Primary Care (NV) PC

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1629857883
  NPD
• Intermountain Medical Holdings Nevada Inc

  • Home Health Agency
  • Las Vegas, NV
  • NPI 1689882557
  NPD
• Anthony L Pollard DO a Professional Corporation

  • Family Medicine Physician
  • Las Vegas, NV
  • NPI 1518189745
  NPD (past)
• Canyon Gate Medical Group, LLC

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1831347731
  NPD (past)
• Centerwell Senior Primary Care (NV) PC

  • Internal Medicine Physician
  • Las Vegas, NV
  • NPI 1083237465
  NPD (past)
• De Craig Ranch, LLC

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1457895336
  NPD (past)
• De Craig Ranch, LLC

  • General Acute Care Hospital
  • North Las Vegas, NV
  • NPI 1578007514
  NPD (past)
• De Craig Ranch, LLC

  • General Acute Care Hospital
  • Las Vegas, NV
  • NPI 1740724780
  NPD (past)
• Dignity Health

  • General Acute Care Hospital
  • Henderson, NV
  • NPI 1447393152
  NPD (past)

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

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1740550078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 BLUE LAGOON DR STE 200",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331263168",
            "telephone_number": "725-258-2982",
            "fax_number": "407-770-0661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4517 BLUE DIAMOND RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891397620",
            "telephone_number": "725-258-2982",
            "fax_number": "877-709-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLEY",
        "first_name": "CHESTER",
        "middle_name": "C. ROBERT",
        "name_suffix": "IV",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-03",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA1517",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA1517",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "V72760",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740550078",
            "state": "NV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "chester.whitley.iv.1@29601.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "4517 Blue Diamond Rd",
            "city": "Las Vegas",
            "state": "NV",
            "country_code": "US",
            "postal_code": "891397620",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Charlene Whiting
• Mark Whiting, DMD
• Susan Whiting, BS
• Tabitha Lois Whiting
• Tanganyka Whiting
• Kelly Whitley
• Louis Whitley
• Tawanda Whitley
• Jazmyne Marilee Whitlow
• Dale D Whitma, MA, CCC-SLP

• Physician Assistant in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physician Assistant in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; 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.
• 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.