Individual provider Active NPI

Donald A Whiting III, EMT

  • Intermediate Emergency Medical Technician
  • San Fidel, NM
National Provider Identifier
1902177371
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intermediate Emergency Medical TechnicianTaxonomy code 146M00000X
License
I7010693 Issued in CO
Practice address
Exit 102 Off I-40 1/2 Mile South
San Fidel, NM 87049-0130
Phone
(505) 552-5385
Fax
(505) 552-5828
NPI assigned
Jan 18, 2012
Last updated
Jan 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intermediate Emergency Medical Technician 146M00000X I7010693 CO Primary

Addresses

Primary practice location

Exit 102 Off I-40 1/2 Mile South
San Fidel, NM 87049-0130

Mailing address

PO Box 130
San Fidel, NM 87049-0130
Phone (505) 552-5385

Other identifiers 1

IdentifierTypeStateIssuer
H3451MedicaidNM

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)
Not enrolled
Credentials
Emergency Medical Technician

State licenses

LicenseStateTypeSpecialty
I7010693COMDIntermediate Emergency Medical Technician

NPI Registry JSON

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1902177371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "SAN FIDEL",
            "state": "NM",
            "postal_code": "870490130",
            "telephone_number": "505-552-5385",
            "fax_number": "505-552-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EXIT 102 OFF I-40 1/2 MILE SOUTH",
            "city": "SAN FIDEL",
            "state": "NM",
            "postal_code": "870490130",
            "telephone_number": "505-552-5385",
            "fax_number": "505-552-5828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITING",
        "first_name": "DONALD",
        "middle_name": "A",
        "name_suffix": "III",
        "credential": "EMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146M00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Intermediate",
            "state": "CO",
            "license": "I7010693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "H3451",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Fidel, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.