Kristy Whelan D O P C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

3773 Issued in AZ

Legal business name

KRISTY WHELAN D O P C

Practice address

2082 Mesquite Ave
Suite 216
Lake Havasu City, AZ 86403-6710

Phone

(908) 680-4233

Fax

(928) 680-6522

NPI assigned

Dec 11, 2007

Organization subpart

No

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

Authorized official

Name

Kristy M Whelan, DONPI 1033214606

Title

Owner

Phone

(928) 680-3388

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kristy M Whelan, DO

  • Family Medicine Physician
  • Lake Havasu City, AZ
  • NPI 1033214606
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1197331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236816000000",
    "number": "1972786101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 645",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864050645",
            "telephone_number": "908-680-4233",
            "fax_number": "928-680-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2082 MESQUITE AVE",
            "address_2": "SUITE 216",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864036710",
            "telephone_number": "908-680-4233",
            "fax_number": "928-680-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTY WHELAN D O P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-11",
        "last_updated": "2009-03-12",
        "status": "A",
        "authorized_official_last_name": "WHELAN",
        "authorized_official_first_name": "KRISTY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "928-680-3388",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "3773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DE9062",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "701632001",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET",
            "identifier": "ZC9409",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS AZ",
            "identifier": "AZ0422120",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aleksander Robert Kohn, OT
• Steve J Kopp, OD PC
• Shane Kortan, RPH.
• Schalene Nicole Kraft, PHARMD
• Carmin Leanne Kress, LPN
• Krystal Telnes, PLLC
• John Kurowsky II, RPH
• Ryan Michael Kurtz, DMD
• Cassandra Kay Kyer, FNP
• La Laser Center PC, a Professional Medical Corporation

• Family Medicine Physician in Lake Havasu City, AZ
• Providers in Lake Havasu City, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.