Jake Arthur Whiteside

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

01096565A Issued in IN

Practice address

30 E Apple St Ste 6258
Dayton, OH 45409-2939

Phone

(937) 208-2951

NPI assigned

Apr 3, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

State licenses

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1790480200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E APPLE ST STE 6258",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 E APPLE ST STE 6258",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454092939",
            "telephone_number": "937-208-2951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITESIDE",
        "first_name": "JAKE",
        "middle_name": "ARTHUR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-03",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IN",
            "license": "01096565A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice Whitecar, MSW, LISW
• Philip S Whitecar, MD
• Ashley Whitehead
• Robert Zachary Whitehead, PTA
• Benjamin Andrew Whitenack, LCDC II
• Diamond Whitfield
• John W Whitfield
• Kim Greene Whitfield, LPN
• Kimberly Whitfield, CDCA
• Tonya Yolanda Whiting

• Student in an Organized Health Care Education/Training Program in Dayton, OH
• Providers in Dayton, OH by specialty
• Student in an Organized Health Care Education/Training Program in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.