Amanda Susanne Whiteley, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD61407506 Issued in WA

Practice address

525 Lilly Rd NE Ste 250
Olympia, WA 98506-5101

Phone

(541) 386-3911

NPI assigned

Feb 7, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX, MN, WA3 enrollments

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 3

Specialty

Psychiatry

Education

University of Texas Medical School at Houston, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Providence Health and Services WashingtonGroup PAC ID 6709782600, 480 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Providence Health & Services Washington

  • Family Medicine Physician
  • Olympia, WA
  • NPI 1174744304
  Medicare reassignment Care Compare group NPD
• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  Medicare reassignment NPD
• Tri-County Clinical

  • Family Medicine Physician
  • Luling, TX
  • NPI 1336456227
  Medicare reassignment NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD
• Seton Family of Doctors

  • Neurological Surgery Physician
  • Austin, TX
  • NPI 1588997233
  NPD (past)
• Seton Family of Doctors

  • Neurological Surgery Physician
  • Kyle, TX
  • NPI 1730412388
  NPD (past)

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1750421756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 RIO GRANDE ST",
            "address_2": "SUITE 340",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787011137",
            "telephone_number": "512-324-8960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 LILLY RD NE STE 250",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065101",
            "telephone_number": "541-386-3911"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3501 Mills Ave",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787316309",
            "country_code": "US",
            "telephone_number": "512-324-2080",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITELEY",
        "first_name": "AMANDA",
        "middle_name": "SUSANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KY",
            "license": "42508",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "N9329",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "MD61407506",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282852701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lyneta Celia White
• Melissa Suzanne White, M.A.
• Noelle E White, PT, DPT
• Peter Grant White, L.AC.
• Sarah White, MSW
• Whitman Counseling Inc.
• Teyani Rain Whitman, LMHC
• Richard Osborn Whitten, MD
• Russhell Francine Whitwam, LMP
• Stephanie Paige Whitworth, P.A.

• Psychiatry Physician in Olympia, WA
• Providers in Olympia, WA by specialty
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2023; 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.