Active NPI
John Whalen, MD
- Nuclear Medicine Physician
- Bayside, WI
National Provider Identifier
1790700185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nuclear Medicine Physician
- License
- 21162
- Practice address
- 500 W Brown Deer Rd
Suite 202
Bayside, WI 53217-1618 - Phone
- (414) 434-0461
- NPI assigned
- Jul 13, 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 |
|---|---|---|---|---|
| Nuclear Medicine Physician | 207U00000X | 21162 | WI | Primary |
Addresses
Primary practice location
500 W Brown Deer Rd
Suite 202
Bayside, WI 53217-1618
Mailing address
500 W Brown Deer Rd
Suite 202
Bayside, WI 53217-1618
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1401321600000",
"number": "1790700185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 W BROWN DEER RD",
"address_2": "SUITE 202",
"city": "BAYSIDE",
"state": "WI",
"postal_code": "532171618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 W BROWN DEER RD",
"address_2": "SUITE 202",
"city": "BAYSIDE",
"state": "WI",
"postal_code": "532171618",
"telephone_number": "414-434-0461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHALEN",
"first_name": "JOHN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-13",
"last_updated": "2014-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "207U00000X",
"taxonomy_group": "",
"desc": "Nuclear Medicine",
"state": "WI",
"license": "21162",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bayside, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.