Thomas Lee Whitehead Jr., FNP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95007261 Issued in CA

Practice address

207 W Legion Rd
Brawley, CA 92227-7780

Phone

(760) 351-3130

Fax

(760) 351-3130

NPI assigned

Sep 5, 2017

Last updated

Sep 5, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: thomas.whitehead.p1@direct.cdsdp.nextgenshare.com

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.

• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • Santa Ana, CA
  • NPI 1548667843
  Medicare reassignment NPD
• Clinicas de Salud del Pueblo, Inc

  dba Innercare

  • Federally Qualified Health Center (FQHC)
  • El Centro, CA
  • NPI 1346313889
  Medicare reassignment NPD
• Legacy MD Medical Group Inc

  • General Practice Physician
  • El Centro, CA
  • NPI 1073210753
  Medicare reassignment NPD
• Cep America - California

  dba Vituity

  • Emergency Medicine Physician
  • Brawley, CA
  • NPI 1073554002
  NPD
• Cep America-California

  • Emergency Medicine Physician
  • Murrieta, CA
  • NPI 1588552848
  NPD
• Clinicas de Salud del Pueblo Inc.

  dba InnerCare Pharmacy

  • Community/Retail Pharmacy
  • El Centro, CA
  • NPI 1962045872
  NPD
• Clinicas de Salud del Pueblo, Inc

  dba Clinicas de Salud del Pueblo

  • Federally Qualified Health Center (FQHC)
  • Calexico, CA
  • NPI 1962599266
  NPD
• Clinicas de Salud del Pueblo, Inc.

  dba Innercare

  • Federally Qualified Health Center (FQHC)
  • Winterhaven, CA
  • NPI 1124109202
  NPD (past)

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

{
    "created_epoch": "1504569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504569600000",
    "number": "1982122560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 VALLE VERDE LN",
            "city": "IMPERIAL",
            "state": "CA",
            "postal_code": "922518003",
            "telephone_number": "769-960-2376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 W LEGION RD",
            "city": "BRAWLEY",
            "state": "CA",
            "postal_code": "922277780",
            "telephone_number": "760-351-3130",
            "fax_number": "760-351-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "THOMAS",
        "middle_name": "LEE",
        "name_suffix": "Jr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-05",
        "last_updated": "2017-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95007261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Qui Jeff Vo, M.D.
• Vons Companies Inc (Vons Pharmacy #1767)
• W Dodson Creighton M D Inc
• Walmart Inc. (WalMart Pharmacy 10-5335)
• Andrew Kenneth Wells
• Mark Whyte, MD
• Jeffrey Wise
• Carissa Woodland, RN, BSN, MSN, SNSC
• Jonta Yancy
• Helen H. Yen, M.D.

• Nurse Practitioner in Brawley, CA
• Providers in Brawley, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.