Individual provider Active NPI

Phillip Michael Whitley

  • Anesthesiology Physician
  • Indianapolis, IN
National Provider Identifier
1801138722
Registry record updated Mar 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
01076557A Issued in IN
Practice address
2001 W 86TH St
Department of Medical Education
Indianapolis, IN 46260-1902
Phone
(317) 338-2345
Fax
(800) 731-0751
NPI assigned
Mar 18, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 01076557A IN Primary

Addresses

Primary practice location

2001 W 86TH St
Department of Medical Education
Indianapolis, IN 46260-1902

Mailing address

PO Box 7232 Dept 165
Indianapolis, IN 46207-7232
Phone (317) 614-9850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20170517001026 IN Practitioner - Anesthesiology 9739311457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Indiana University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northside Anesthesia Services, LLCGroup PAC ID 7719891027, 94 clinicians

Practice addresses (Care Compare)

2001 W 86TH St
Indianapolis, IN 46260-1902
Phone (317) 338-2345

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Organizations & group practices 1

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1801138722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7232 DEPT 165",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462077232",
            "telephone_number": "317-614-9850",
            "fax_number": "317-614-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 W 86TH ST",
            "address_2": "DEPARTMENT OF MEDICAL EDUCATION",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601902",
            "telephone_number": "317-338-2345",
            "fax_number": "800-731-0751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLEY",
        "first_name": "PHILLIP",
        "middle_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-03-18",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "01076557A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

Verify at the official NPI Registry.