Travis David Whitehead, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

054047 Issued in GA

Practice address

6 Player CT NW
Rome, GA 30165-2566

Phone

(706) 291-0301

NPI assigned

Jun 14, 2006

Last updated

Dec 29, 2011By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA, IL2 enrollments

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 2

Specialty

Emergency Medicine

Education

Mercer University School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwest Emergency Good Samaritan, IncGroup PAC ID 1658529342, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Good Samaritan Regional HLTH Center Hospital, Mount Vernon, IL, CCN 140046
• SSM Health St Mary's Hospital -Centralia Hospital, Centralia, IL, CCN 140034

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: twhitehead82073@direct-ehr-ssmhc.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.

• Midwest Emergency Good Samaritan, Inc

  • Emergency Medicine Physician
  • Mount Vernon, IL
  • NPI 1629367578
  Medicare reassignment Care Compare group NPD
• Hartwell Emergency Physicians LLC

  • Emergency Medicine Physician
  • Hartwell, GA
  • NPI 1962540849
  Medicare reassignment NPD
• Midwest Emergency Centralia Campus Associates, Inc

  • Emergency Medicine Physician
  • Centralia, IL
  • NPI 1396034245
  Medicare reassignment NPD
• Midwest Emergency Sparta, Inc

  • Emergency Medicine Physician
  • Sparta, IL
  • NPI 1194162370
  Medicare reassignment NPD
• Salem Township Hospital

  • Critical Access Hospital
  • Salem, IL
  • NPI 1295739548
  Medicare reassignment NPD
• Hartwell Emergency Physicians LLC

  • Emergency Medicine Physician
  • Lavonia, GA
  • NPI 1467710152
  NPD
• Salem Township Hospital

  dba STH Family Health Care Center

  • Rural Health Clinic/Center
  • Salem, IL
  • NPI 1649830472
  NPD
• Carter Emergency Physicians

  • Emergency Medicine Physician
  • Elberton, GA
  • NPI 1356377022
  NPD (past)
• Fannin Ed Physicians LLC

  • Emergency Medicine Physician
  • Blue Ridge, GA
  • NPI 1871791277
  NPD (past)
• Hargrave Emergency Physicians LLC

  • Emergency Medicine Physician
  • Fort Oglethorpe, GA
  • NPI 1760744668
  NPD (past)
• Harmony Grove Emergency Physicians LLC

  • Emergency Medicine Physician
  • Riverdale, GA
  • NPI 1093331308
  NPD (past)
• Harmony Grove Emergency Physicians LLC

  • Emergency Medicine Physician
  • Commerce, GA
  • NPI 1144495797
  NPD (past)

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

• Good Samaritan Regional Health Center

  dba SSM Health Good Samaritan Hospital - Mt. Vernon

  • General Acute Care Hospital
  • Mount Vernon, IL
  • NPI 1609897339
  Care Compare affiliation
• St Mary's Hospital, Centralia, Illinois

  dba SSM Health St. Mary's Hospital - Centralia

  • General Acute Care Hospital
  • Centralia, IL
  • NPI 1083617245
  Care Compare affiliation

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325116800000",
    "number": "1992748297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 PLAYER CT NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652566",
            "telephone_number": "706-291-0301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 PLAYER CT NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652566",
            "telephone_number": "706-291-0301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHEAD",
        "first_name": "TRAVIS",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2011-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "20444",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "GA",
            "license": "054047",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "053109813A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael L White, PAC
• Tosha Michelle White, AGACNP-BC
• James Chadwick Whitefield, PTA
• Whitehall Wellness Center (Paxton Chiropractic)
• Kathrine Jebian Whitehead, MD
• Zachary Carl Whitener, NP-C
• Adam Scott Whittemore, PA-C
• Alex William Widmer, RT R VI
• Alice Eleanor Wiener, PSY.D.
• Sonia Wiggins

• Emergency Medicine Physician in Rome, GA
• Providers in Rome, GA by specialty
• Emergency Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.