Individual provider Active NPI

George Russell Whetton, DC

  • Chiropractor
  • Yucca Valley, CA
National Provider Identifier
1881651719
Registry record updated Mar 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
110565-1202 Issued in UT
Practice address
57407 29 Palms Hwy
Suite a
Yucca Valley, CA 92284-2907
Phone
(760) 369-0593
Fax
(760) 369-1097
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 110565-1202 UT Primary
Nutrition Chiropractor 111NN1001X 11533 CA

Addresses

Primary practice location

57407 29 Palms Hwy
Suite a
Yucca Valley, CA 92284-2907

Mailing address

57407 29 Palms Hwy Ste a
Yucca Valley, CA 92284-2907
Phone (760) 369-0593

Other identifiers 3

IdentifierTypeStateIssuer
52825677903001OtherUTBLUE CROSS
360947200OtherUTMAIL HANDLERS
D5227MedicaidUT

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
11533CAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268352000000",
    "number": "1881651719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57407 29 PALMS HWY STE A",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922842907",
            "telephone_number": "760-369-0593",
            "fax_number": "760-369-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57407 29 PALMS HWY",
            "address_2": "SUITE A",
            "city": "YUCCA VALLEY",
            "state": "CA",
            "postal_code": "922842907",
            "telephone_number": "760-369-0593",
            "fax_number": "760-369-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHETTON",
        "first_name": "GEORGE",
        "middle_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2010-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "UT",
            "license": "110565-1202",
            "primary": true
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "CA",
            "license": "11533",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "52825677903001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAIL HANDLERS",
            "identifier": "360947200",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D5227",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Yucca Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2010; 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.