Bruce Lee Whitaker Jr., DO

Primary specialty

Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X

License

OC-0415 Issued in ID

Practice address

1350 Walton Way
Augusta, GA 30901-2612

Phone

(706) 774-7745

Fax

(706) 774-5789

NPI assigned

Jan 27, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI, GA, ID, AZ, AL5 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 5

Specialty

Critical Care (Intensivists)

Education

Michigan State University College of Osteopathic Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Houston County Healthcare AuthorityGroup PAC ID 9436062296, 256 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IIFJBD
• FHIR API: https://fhir4.healow.com/fhir/r4/ACBBDA
• Direct secure messaging: bwhitaker1262619@nychhc.direct-ci.com
• Direct secure messaging: bwhitaker3186330@direct.trinity-health.org

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Baptist Home Association of the Rocky Mountains Inc

  • Skilled Nursing Facility
  • Denver, CO
  • NPI 1831187632

  Corporate Director

  CMS ownership

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.

• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606

  AL, Family Medicine

  Medicare reassignment Care Compare group NPD
• Advantage Health/Saint Mary'S Medical Group

  • Multi-Specialty Clinic/Center
  • Grand Rapids, MI
  • NPI 1376862151

  MI

  Medicare reassignment NPD
• Apogee Medical Group, Michigan, PC

  • Internal Medicine Physician
  • Scottsdale, AZ
  • NPI 1053655134

  Internal Medicine, MI

  Medicare reassignment NPD
• Bronson Battle Creek Hospital

  • Internal Medicine Physician
  • Battle Creek, MI
  • NPI 1093119638

  Family Medicine, MI

  Medicare reassignment NPD
• Bronson Methodist Hospital

  • Hospitalist Physician
  • Kalamazoo, MI
  • NPI 1417961137

  MI

  Medicare reassignment NPD
• Covenant Medical Center, Inc.

  • Emergency Medicine Physician
  • Saginaw, MI
  • NPI 1972590412

  MI

  Medicare reassignment NPD
• Edward W. Sparrow Hospital Association

  • Pediatrics Physician
  • Lansing, MI
  • NPI 1831139088

  MI

  Medicare reassignment NPD
• Hospitalist Physicians Medical Group of Michigan, PC

  • Emergency Medicine Physician
  • Chelsea, MI
  • NPI 1003978867

  MI

  Medicare reassignment NPD
• Portage Physician Practices Inc

  • Internal Medicine Physician
  • Hancock, MI
  • NPI 1225461684

  Family Medicine, MI

  Medicare reassignment NPD
• Saint Alphonsus Regional Medical Center Inc

  • Psychologist
  • Boise, ID
  • NPI 1649357716

  ID

  Medicare reassignment NPD
• Sound Physicians Intensivists of Arizona, Inc

  • Internal Medicine Physician
  • Tucson, AZ
  • NPI 1962944702

  AZ, Family Medicine

  Medicare reassignment NPD
• Umg Infectious Disease LLC

  • Infectious Disease Physician
  • Augusta, GA
  • NPI 1306260880
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Houston County Healthcare Authority

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1164403861

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1233014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1790923969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1705",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309031705",
            "telephone_number": "706-854-6008",
            "fax_number": "706-774-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 WALTON WAY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309012612",
            "telephone_number": "706-774-7745",
            "fax_number": "706-774-5789"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2525 W University Ave",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Muncie",
            "state": "IN",
            "postal_code": "473033400",
            "country_code": "US",
            "telephone_number": "586-214-8113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7777 Hennessy Blvd Ste 409",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708084365",
            "country_code": "US",
            "telephone_number": "225-765-5864",
            "fax_number": "225-765-2013",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1055 N Curtis Rd",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837061309",
            "country_code": "US",
            "telephone_number": "208-302-2000",
            "fax_number": "208-302-2055",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "BRUCE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-27",
        "last_updated": "2024-02-05",
        "certification_date": "2024-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "5101016483",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "LA",
            "license": "062124",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MI",
            "license": "5101016483",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "ID",
            "license": "OC-0415",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0E00425",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790923969",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherrie Lynn Wheeler
• Frank Eugene Whelchel, RPH
• Kayla Jean Whelchel, CRNA
• Robert Dean Whigham, N.P.
• Ebony B Whisenant, M.D.
• Derek Casper Whitaker, M.D.
• Lissete Arias Whitaker
• Abigail B. White, CRNA
• Andrew Wesley White, M.D.
• April White

• Critical Care Medicine (Internal Medicine) Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Critical Care Medicine (Internal Medicine) Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.