Active NPI
Clayton E Whitney, MD
- Ophthalmology Physician
- Tyler, TX
National Provider Identifier
1780655340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- G0285
- Practice address
- 1327 Troup Hwy
Tyler, TX 75701-4443 - Phone
- (903) 531-4733
- NPI assigned
- Jan 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | G0285 | TX | Primary |
Addresses
Primary practice location
1327 Troup Hwy
Tyler, TX 75701-4443
Mailing address
PO Box 846098
Dallas, TX 75284-6098
Phone (903) 324-6450
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 123448604 | Medicaid | TX | |
| 8BC079 | Other | TX | BCBS OF TEXAS |
| 123448605 | Medicaid | TX | |
| TIN PLUS 021 | Other | TX | TRICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G0285 | TX | MD | Ophthalmology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Texas Southwestern Medical Center at Dallas | Current | Accepting new patients | |
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| Christus Trinity Clinic Texas | Current | Accepting new patients | |
| University of Texas Southwestern Medical Center at Dallas | Ophthalmology | Current | Accepting new patients |
| The University of Texas Southwestern Medical Center at Dallas | Current | Accepting new patients |
Locations
10057 County Road 472
Anna, TX 75409
5201 Harry Hines Blvd
Dallas, TX 75235
Phone (214) 590-1396
3203 S Main St
Lindale, TX 75771
Phone (903) 266-4000
1327 Troup Hwy
Tyler, TX 75701
Phone (903) 510-8764
630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888
Organizations & group practices 5
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.
-
- Family Medicine Physician
- Tyler, TX
- NPI 1285684225
-
- Anesthesiology Physician
- Dallas, TX
- NPI 1942270566
-
- Rural Health Clinic/Center
- Winnsboro, TX
- NPI 1801673165
-
- Clinical Medical Laboratory
- Dallas, TX
- NPI 1396832713
-
- Ophthalmology Physician
- Dallas, TX
- NPI 1851361471
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1413244800000",
"number": "1780655340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 846098",
"city": "DALLAS",
"state": "TX",
"postal_code": "752846098",
"telephone_number": "903-324-6450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1327 TROUP HWY",
"city": "TYLER",
"state": "TX",
"postal_code": "757014443",
"telephone_number": "903-531-4733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITNEY",
"first_name": "CLAYTON",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-31",
"last_updated": "2014-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "TX",
"license": "G0285",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "123448604",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TEXAS",
"identifier": "8BC079",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "123448605",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "TIN PLUS 021",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; 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.