Individual provider Active NPI

James Vernon Whitley, FNP

  • Family Nurse Practitioner
  • San Antonio, TX
National Provider Identifier
1962486852
Registry record updated Apr 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
620929 Issued in TX
Practice address
4360 Greco Dr
San Antonio, TX 78222-2725
Phone
(210) 648-8200
Fax
(855) 392-7988
NPI assigned
Dec 4, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 620929 TX Primary

Addresses

Primary practice location

4360 Greco Dr
San Antonio, TX 78222-2725

Mailing address

711 Navarro St Ste 600
San Antonio, TX 78205-1892
Phone (844) 630-0700

Other identifiers 3

IdentifierTypeStateIssuer
AP110207OtherTXRN LICENSE
149615004MedicaidTX
AP110207OtherTXAPN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031217000772 TX Practitioner - Nurse Practitioner 4688571672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TMC Provider Group PLLCGroup PAC ID 6305149121, 213 clinicians

Practice addresses (Care Compare)

23611W Interstate 10
San Antonio, TX 78257-1694
Phone (210) 698-6617

7460N Interstate 35
San Antonio, TX 78218-2700
Phone (210) 655-5529

8341 Agora Pkwy
Selma, TX 78154-1316
Phone (210) 659-5533

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
620929TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Provider Group PLLC CurrentSince May 10, 2023 Accepting new patients
TMC Provider Group PLLC CurrentSince May 10, 2023 Accepting new patients
TMC Provider Group PLLC Current Accepting new patients
St. David'S Carenow Urgent Care PLLC Past Accepting new patients
GMG Health Systems Associates PA PastSince Dec 27, 2009 Accepting new patients

Locations

9900 S Interstate 35
Austin, TX 78748
Phone (512) 291-5577

13722 Embassy Row
San Antonio, TX 78216
Phone (210) 349-5577

23611 W Interstate 10
San Antonio, TX 78257
Phone (210) 698-6617

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1133654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524700800000",
    "number": "1962486852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 NAVARRO ST STE 600",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782051892",
            "telephone_number": "844-630-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4360 GRECO DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782222725",
            "telephone_number": "210-648-8200",
            "fax_number": "855-392-7988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLEY",
        "first_name": "JAMES",
        "middle_name": "VERNON",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-04",
        "last_updated": "2018-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "620929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "AP110207",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "149615004",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APN LICENSE",
            "identifier": "AP110207",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.