Kaili Whiteaker, FNP-C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0998421 Issued in CO

Practice address

75 Printers Pkwy
Colorado Springs, CO 80910-3151

Phone

(719) 300-8433

Fax

(719) 300-7796

NPI assigned

Mar 9, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Fraser Professional Medical Group LLC

  dba Flying Horse Medical Center

  • Family Medicine Physician
  • Colorado Springs, CO
  • NPI 1184045726
  Medicare reassignment NPD

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1841990512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 PRINTERS PKWY STE 200",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103142",
            "telephone_number": "719-300-8433",
            "fax_number": "719-300-7796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 PRINTERS PKWY",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103151",
            "telephone_number": "719-300-8433",
            "fax_number": "719-300-7796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEAKER",
        "first_name": "KAILI",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-09",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "0998421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Takara Joy White
• Tory Lynn White
• Tristan R White
• Wendy White
• Zora White
• Megan Ashley Whited, LMT
• Barbara Whitehart
• Kelly Ann Whitehead, MOTR/L
• Shannon Michelle Whitehead, LMT, CNMT
• Thomas Whiteman

• Family Medicine Physician in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Family Medicine Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.