Individual provider Active NPI

Alexander Scott Whelan, MD

  • Emergency Medicine Physician
  • Fort Defiance, AZ
National Provider Identifier
1851702054
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35.132155 Issued in OH
Practice address
Corner of Routes N12 & N7
Fort Defiance, AZ 86504
Phone
(928) 729-8608
NPI assigned
May 12, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230214002791 ID Practitioner - Emergency Medicine 7214202472 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD51445SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shoshone Medical Center CurrentSince May 22, 2024 Accepting new patients
Shoshone Medical Center CurrentSince May 22, 2024 Accepting new patients

Locations

25 Jacobs Gulch Rd
Kellogg, ID 83837
Phone (208) 784-1221

Interoperability endpoints

  • FHIR API: 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.

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

Verify at the official NPI Registry.