Timothy Whitehead, MD

Primary specialty

Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X

License

036-132985 Issued in IL

Practice address

530 NE Glen Oak Ave
Peoria, IL 61637-5429

Phone

(309) 655-2000

NPI assigned

Jun 7, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL, MN, WI, IA4 enrollments

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 4

Specialty

Interventional Radiology

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gundersen Lutheran Medical Center IncGroup PAC ID 2163331414, shared by 16 NPIs, 888 clinicians

Saint Elizabeths Hospital of Wabasha IncGroup PAC ID 5092619387, 93 clinicians

Tri-County Memorial Hospital IncGroup PAC ID 4587642418, 75 clinicians

Veterans Memorial Hospital City of Waukon IaGroup PAC ID 1355230293, shared by 6 NPIs, 40 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Gundersen Lutheran Medical Center Hospital, La Crosse, WI, CCN 520087
• Gundersen Tri-County Hospital & Clinics Hospital, Whitehall, WI, CCN 521316
• Tomah Memorial Hospital Hospital, Tomah, WI, CCN 521320
• Gundersen Palmer Lutheran Hospital and Clinics Hospital, West Union, IA, CCN 161316
• Gundersen Boscobel Area Hospital and Clinics Hospital, Boscobel, WI, CCN 521344

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: twhitehead823644@direct.emplifyhealth.org

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.

• Saint Elizabeths Hospital of Wabasha Inc

  dba Gundersen St. Elizabeth's Hospital and Clinics

  • Critical Access Hospital
  • Wabasha, MN
  • NPI 1659355600

  WI

  Medicare reassignment Care Compare group NPD
• Tri-County Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Whitehall, WI
  • NPI 1417201864
  Medicare reassignment Care Compare group NPD
• Black River Health Inc

  • Critical Access Hospital
  • Black River Falls, WI
  • NPI 1811940331
  Medicare reassignment NPD
• Gundersen Clinic LTD

  • Clinic/Center
  • La Crosse, WI
  • NPI 1851343115

  IA, MN

  Medicare reassignment NPD
• Gundersen Lutheran Medical Center Inc

  dba Emplify Health Hamilton Clinic

  • Clinic/Center
  • La Crosse, WI
  • NPI 1225873458
  Medicare reassignment NPD
• Gundersen Lutheran Medical Center Inc

  dba Emplify Health La Crosse Hospital

  • General Acute Care Hospital
  • La Crosse, WI
  • NPI 1376593442

  MN

  Medicare reassignment NPD
• Memorial Hospital of Boscobel

  dba Gundersen Boscobel Area Hospital and Clinics

  • Critical Access Hospital
  • Boscobel, WI
  • NPI 1760459846
  Medicare reassignment NPD
• Moundview Memorial Hospital & Clinics, Inc

  dba Gundersen Moundview Hospital and Clinics, Inc.

  • Critical Access Hospital
  • Friendship, WI
  • NPI 1710939533
  Medicare reassignment NPD
• Richland Hospital

  • Critical Access Hospital
  • Richland Center, WI
  • NPI 1659301273
  Medicare reassignment NPD
• St. Joseph's Health Services, Inc.

  • Clinic/Center
  • Hillsboro, WI
  • NPI 1104031798
  Medicare reassignment NPD
• Tomah Memorial Hospital Inc

  dba Tomah Health

  • Critical Access Hospital
  • Tomah, WI
  • NPI 1184765240
  Medicare reassignment NPD
• Tomah Memorial Hospital Inc

  dba Tomah Health

  • Critical Access Hospital
  • Tomah, WI
  • NPI 1992970453

  Diagnostic Radiology

  Medicare reassignment NPD

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

• Gundersen Lutheran Medical Center Inc

  dba Emplify Health La Crosse Hospital

  • General Acute Care Hospital
  • La Crosse, WI
  • NPI 1376593442
  Care Compare affiliation
• Gundersen Lutheran Medical Center Inc

  dba Emplify Health Pediatric Mobile Unit

  • Clinic/Center
  • La Crosse, WI
  • NPI 1790646719

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center Inc

  dba Emplify Health Winona Campus

  • Clinic/Center
  • Winona, MN
  • NPI 1952959603

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center, Inc

  dba Emplify Health Onalaska Clinic

  • Clinic/Center
  • Onalaska, WI
  • NPI 1225372923

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center, Inc

  dba Emplify Health East Building

  • Clinic/Center
  • La Crosse, WI
  • NPI 1497090138

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center, Inc

  dba Emplify Health Onalaska Behavioral Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Onalaska, WI
  • NPI 1871837567

  Hospital

  Care Compare affiliation
• Gundersen Lutheran Medical Center, Inc.

  dba Emplify Health

  • Air Ambulance
  • La Crosse, WI
  • NPI 1467468173

  Hospital

  Care Compare affiliation
• Memorial Hospital of Boscobel

  dba Gundersen Boscobel Area Hospital and Clinics

  • Critical Access Hospital
  • Boscobel, WI
  • NPI 1760459846
  Care Compare affiliation
• Palmer Lutheran Health Center, Inc.

  dba Gundersen Palmer Lutheran Hospital and Clinics

  • Critical Access Hospital
  • West Union, IA
  • NPI 1598765398
  Care Compare affiliation
• Tomah Memorial Hospital Inc

  dba Tomah Health

  • Critical Access Hospital
  • Tomah, WI
  • NPI 1184765240
  Care Compare affiliation
• Tri-County Memorial Hospital, Inc.

  • Critical Access Hospital
  • Whitehall, WI
  • NPI 1124063573
  Care Compare affiliation
• Tri-County Memorial Hospital, Inc.

  • Rural Health Clinic/Center
  • Whitehall, WI
  • NPI 1417201864

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1212796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697155200000",
    "number": "1871752428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 OAKWOOD RD",
            "city": "EAST PEORIA",
            "state": "IL",
            "postal_code": "616111853",
            "telephone_number": "309-740-4272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616375429",
            "telephone_number": "309-655-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "TIMOTHY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-07",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.123822",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "WI",
            "license": "82252",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "OH",
            "license": "35.123822",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IL",
            "license": "036-132985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0104941",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "35.123822",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karla Jean White, LCPC
• Kristina White, PHARMD
• Melissa Marie White, PT
• Robert Scott White, M.D.
• Tina White, FNP
• Michelle L Whitelow, NURSE PRACTITIONER
• Tyler Daniel Whitney, DNP, APRN, ACNP-AG
• Gretchen Marie Whittemore, MA, LCPC
• John Patrick Whitten, MD
• Patrick E Whitten, M.D.

• Vascular & Interventional Radiology Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Vascular & Interventional Radiology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.