Individual provider Active NPI

Gerald L Whiteside, AUD

  • Audiologist
  • Lawrence, KS
National Provider Identifier
1801863477
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
1983 Issued in KS
Practice address
1112 W 6TH St
Suite 100
Lawrence, KS 66044-2249
Phone
(785) 843-8479
Fax
(785) 843-8481
NPI assigned
Mar 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 1252 KS
Audiologist 231H00000X 1983 KS Primary

Addresses

Primary practice location

1112 W 6TH St
Suite 100
Lawrence, KS 66044-2249

Mailing address

1112 W 6TH St
Suite 100
Lawrence, KS 66044-2249
Phone (785) 843-8479

Other identifiers 4

IdentifierTypeStateIssuer
11839028OtherCAQH
39948015OtherBCBS OF KANSAS CITY
115852OtherBCBS OF KANSAS
200386610AMedicaidKS

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

State licenses

LicenseStateTypeSpecialty
1252KSMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Audiologists Inc Audiologist CurrentSince Aug 2, 2022 Accepting new patients

Locations

1112 W 6th St
Ste 100
Lawrence, KS 66044
Phone (785) 843-8479

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.

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1801863477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 W 6TH ST",
            "address_2": "SUITE 100",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660442249",
            "telephone_number": "785-843-8479",
            "fax_number": "785-843-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 W 6TH ST",
            "address_2": "SUITE 100",
            "city": "LAWRENCE",
            "state": "KS",
            "postal_code": "660442249",
            "telephone_number": "785-843-8479",
            "fax_number": "785-843-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITESIDE",
        "first_name": "GERALD",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "AUD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "KS",
            "license": "1252",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "KS",
            "license": "1983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11839028",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KANSAS CITY",
            "identifier": "39948015",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF KANSAS",
            "identifier": "115852",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200386610A",
            "state": "KS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.