Individual provider Active NPI

Autumn Beth Whitlock-Morales, MD

  • Pediatrics Physician
  • Kingsville, TX
National Provider Identifier
1972539302
Registry record updated Apr 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
R9558 Issued in TX
Practice address
1311 E General Cavazos Blvd Ste 201
Kingsville, TX 78363-7123
Phone
(361) 595-2223
Fax
(361) 595-9687
NPI assigned
Jun 25, 2006
Last updated
Apr 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 22119 WV
Internal Medicine Physician 207R00000X 39466 IA
Pediatrics Physician 208000000X 39466 IA
Pediatrics Physician 208000000X R9558 TX Primary

Addresses

Primary practice location

1311 E General Cavazos Blvd Ste 201
Kingsville, TX 78363-7123

Mailing address

2900 Saint Michael Dr Ste 401
Texarkana, TX 75503-5211
Phone (903) 614-5372

Other identifiers 2

IdentifierTypeStateIssuer
PENDINGMedicaidTX
3810005860MedicaidWV

Other names 1

  • Autumn Beth Whitlock-Morales Professional name

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200619001813 TX Practitioner - Pediatric Medicine 5294739660 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

1311 E General Cavazos Blvd
Kingsville, TX 78363-7123

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

PO Box
Suite 846098
Dallas, TX 75284-6098

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39466IAMDInternal Medicine Physician
R9558TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Internal Medicine CurrentSince Jan 1, 2021 Accepting new patients
C H Wilkinson Physician Network Internal Medicine CurrentSince Aug 3, 2020 Accepting new patients
C H Wilkinson Physician Network CurrentSince Aug 3, 2020 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jan 1, 2021 Accepting new patients
Christus Spohn Health System Corporation Past Accepting new patients

Locations

1276 S Peachtree St
Jasper, TX 75951
Phone (409) 384-5701

1311 Gen Cvazos Blvd
Ste 1
Kingsville, TX 78363
Phone (361) 592-8531

2900 Saint Michael Dr
Ste 401
Texarkana, TX 75503
Phone (903) 614-5353

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: amoraleswhitlock249091@christushealth.direct-ci.net
  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1972539302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 SAINT MICHAEL DR STE 401",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755035211",
            "telephone_number": "903-614-5372",
            "fax_number": "903-614-5343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 E GENERAL CAVAZOS BLVD STE 201",
            "city": "KINGSVILLE",
            "state": "TX",
            "postal_code": "783637123",
            "telephone_number": "361-595-2223",
            "fax_number": "361-595-9687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLOCK-MORALES",
        "first_name": "AUTUMN",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WV",
            "license": "22119",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "39466",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IA",
            "license": "39466",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R9558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810005860",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUTUMN",
            "last_name": "WHITLOCK-MORALES",
            "middle_name": "BETH",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Kingsville, TX

Sources for this page

Verify at the official NPI Registry.