Active NPI
George Russell Whetton, DC
- Chiropractor
- Yucca Valley, CA
National Provider Identifier
1881651719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 110565-1202
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52825677903001 | Other | UT | BLUE CROSS |
| 360947200 | Other | UT | MAIL HANDLERS |
| D5227 | Medicaid | UT |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 11533 | CA | MD | Addiction (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.