Active NPI
Alexander Scott Whelan, MD
- Emergency Medicine Physician
- Fort Defiance, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 35.132155
- Practice address
- Corner of Routes N12 & N7
Fort Defiance, AZ 86504 - Phone
- (928) 729-8608
- NPI assigned
- May 12, 2014
- Last updated
- Jul 21, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | MD51445 | SC | |
| Emergency Medicine Physician | 207P00000X | 35.132155 | OH | Primary |
Addresses
Primary practice location
Corner of Routes N12 & N7
Fort Defiance, AZ 86504
Mailing address
PO Box 2060
Fort Defiance, AZ 86504-2060
Phone (480) 859-3940
Other practice location 1
233 N Main St Apt 406
Greenville, SC 29601-2144
Phone (480) 859-3940
Other practice location 2
2601 E Roosevelt St
Maricopa Integrated Health System
Phoenix, AZ 85008-4973
Phone (602) 344-5956
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD51445 | SC | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shoshone Medical Center | Current | Accepting new patients | |
| Shoshone Medical Center | Current | Accepting new patients |
Locations
25 Jacobs Gulch Rd
Kellogg, ID 83837
Phone (208) 784-1221
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/9a0a9763-cc6e-4ca0-bdec-c16291c965b9/
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Critical Access Hospital
- Kellogg, ID
- NPI 1043215437
-
- Rural Health Clinic/Center
- Smelterville, ID
- NPI 1487272399
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1399852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1851702054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2060",
"city": "FORT DEFIANCE",
"state": "AZ",
"postal_code": "865042060",
"telephone_number": "480-859-3940"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CORNER OF ROUTES N12 & N7",
"city": "FORT DEFIANCE",
"state": "AZ",
"postal_code": "86504",
"telephone_number": "928-729-8608"
}
],
"practiceLocations": [
{
"address_1": "233 N Main St Apt 406",
"address_purpose": "LOCATION",
"city": "Greenville",
"state": "SC",
"postal_code": "296012144",
"country_code": "US",
"telephone_number": "480-859-3940",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2601 E Roosevelt St",
"address_2": "Maricopa Integrated Health System",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850084973",
"country_code": "US",
"telephone_number": "602-344-5956",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WHELAN",
"first_name": "ALEXANDER",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-12",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "SC",
"license": "MD51445",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OH",
"license": "35.132155",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Defiance, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.