Individual provider Active NPI

Ralph Samuel Whallon II, M.D.

  • Family Medicine Physician
  • Scottsdale, AZ
National Provider Identifier
1962814491
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
52386 Issued in AZ
Practice address
8705 E McDowell Rd
Scottsdale, AZ 85257-3909
Phone
(480) 882-4545
Fax
(480) 946-6997
NPI assigned
Jun 2, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 52386 AZ Primary

Addresses

Primary practice location

8705 E McDowell Rd
Scottsdale, AZ 85257-3909

Mailing address

7500 N Dreamy Draw Dr Ste 145
Phoenix, AZ 85020-4668
Phone (480) 882-4545

Other practice location 1

9015 N 3rd St
Phoenix, AZ 85020-2444
Phone (480) 882-4545

Other identifiers 1

IdentifierTypeStateIssuer
280191MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170811000004 AZ Practitioner - Family Practice 1658697677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arizona College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

20440 N 27TH Ave
Phoenix, AZ 85027-3240
Phone (480) 882-4545

8705 E McDowell Rd
Scottsdale, AZ 85257-3909
Phone (480) 882-4545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
52386AZMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Neighborhood Outreach Access to Health Family Medicine CurrentSince Jul 1, 2017 Accepting new patients
Neighborhood Outreach Access to Health CurrentSince Jul 1, 2017 Accepting new patients

Locations

11851 N 51st Ave
Ste B110
Glendale, AZ 85304

11851 N 51st Ave
Ste F140
Glendale, AZ 85304
Phone (623) 428-0001

16251 N Cave Creek Rd
Phoenix, AZ 85032

4131 N 24th St
Ste B102
Phoenix, AZ 85016
Phone (602) 955-6632

20440 N 27th Ave
Phoenix, AZ 85027

7500 N Dreamy Draw Dr
Ste 145
Phoenix, AZ 85020

9015 N 3rd St
Phoenix, AZ 85020

9201 N 5th St
Phoenix, AZ 85020
Phone (602) 331-5817

1300 N 48th St
Phoenix, AZ 85008
Phone (480) 882-5917

11130 E Cholla St
Bldg 1
Scottsdale, AZ 85259

7301 E 2nd St
Ste 210
Scottsdale, AZ 85251
Phone (480) 534-4515

8705 E McDowell Rd
Scottsdale, AZ 85257

Organizations & group practices 2

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": "1401667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1962814491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7500 N DREAMY DRAW DR STE 145",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204668",
            "telephone_number": "480-882-4545",
            "fax_number": "480-882-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8705 E MCDOWELL RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852573909",
            "telephone_number": "480-882-4545",
            "fax_number": "480-946-6997"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9015 N 3rd St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850202444",
            "country_code": "US",
            "telephone_number": "480-882-4545",
            "fax_number": "602-870-6348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHALLON",
        "first_name": "RALPH",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-06-02",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "52386",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "280191",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.