DR. SHANE DONALD WHITELEY (NPI# 1003849449) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003849449 |
| Entity Type | Individual |
| Full Name | DR. SHANE DONALD WHITELEY |
| Credential | DC |
| Practice Address |
1400 Se Goldtree Dr # 207 Port St Lucie FL 34952 |
| Mailing Address |
1400 Se Goldtree Dr # 207 Port St. Lucie FL 34952 |
| Practice Telephone | 7727772836 |
| Practice Fax Number | 7727772837 |
| Mailing Telephone | 7727772836 |
| Mailing Fax Number | 7727772837 |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2013-05-16 |
| NPI Deactivation Date | 02/27/2013 |
| NPI Reactivation Date | 2013-05-07 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | CH10830 | FL | Chiropractic Providers |
| N | 111N00000X | Chiropractor | DC26258 | CA | Chiropractic Providers |
| Street Address |
1400 SE GOLDTREE DR # 207 |
| City | PORT ST LUCIE |
| State | FL |
| Zip Code | 34952 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174521595 | Adam D Kurtin | Surgery | 1400 Se Goldtree Dr, Suite 102-104, Port St Lucie, FL 34952-7582 | 2005-07-09 |
| 1184025728 | Aimee Elizabeth Farmer | Physician Assistant | 1400 Se Goldtree Dr, Ste 103, Port St Lucie, FL 34952-7582 | 2014-09-15 |
| 1073878872 | Diane Marie Krutzler | Surgery | 1400 Se Goldtree Dr, Ste 102-104, Port St Lucie, FL 34952-7582 | 2012-07-08 |
| 1528371895 | Shoshana Deann Hacker | Surgery | 1400 Se Goldtree Dr, Suite 102-104, Port St Lucie, FL 34952-7582 | 2010-07-15 |
| 1982725230 | Jeffrey Alan Tucker | Physical Therapist | 1400 Se Goldtree Dr, Suite 205, Port St Lucie, FL 34952-7582 | 2007-04-03 |
| 1417067844 | Premier Physical Therapy Sport Medicine Inc | Physical Therapist | 1400 Se Goldtree Dr, Ste 205, Port St Lucie, FL 34952-7582 | 2006-08-30 |
| 1528066941 | Rene Mario Loyola | Surgery | 1400 Se Goldtree Dr, Suite 102-104, Port St Lucie, FL 34952-7582 | 2005-07-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215587068 | Carehere LLC | Family Medicine | Carehere Clinic- St. Lucie Psl, 1680 Se Lyngate Drive, Port St Lucie, FL 34952 | 2019-09-13 |
| 1255998274 | Morningside Alf | Assisted Living Facility | 2233 Se Mroningside Alf, Port Saint Lucie, FL 34952 | 2019-05-24 |
| 1336611870 | Med Braces and Supplies, LLC | Durable Medical Equipment & Medical Supplies | 1484 Se Village Green Dr, Port St Lucie, FL 34952 | 2018-12-21 |
| 1689143794 | The Gift of Recovery, LLC | Counselor | 1801 Sw Hillmoor Drive, Suite C-101, Port St. Lucie, FL 34952 | 2018-11-19 |
| 1457830853 | Cathy L Sonier | Counselor | 357 Brazilian Circle, Port St Lucie, FL 34952 | 2018-08-07 |
| 1548756661 | Blo 7 Diabetes Institute Inc | Nutritionist | 1700 Sw Hillmoor Dr., Suite 305, Port St. Lucie, FL 34952 | 2018-07-02 |
| 1780194464 | Doctor's Choice Medical Center | Clinic/Center | 9164 S Us Highway 1, Port St Lucie, FL 34952 | 2017-10-06 |
| 1801305644 | Thandiwe Daley | Behavior Technician | 1935 Se Hillmoor Drive, Apt#159, Port St Lucie, FL 34952 | 2017-09-25 |
| 1700309408 | Lagrand Evan Andrews | Assistant Behavior Analyst | 265 Se Lenard Rd. Apartment 307, Port St. Lucie, FL 34952 | 2017-07-25 |
| 1578085148 | Lavetta S Ivey | Behavior Technician | 7190 Us Federal Hwy 1, Port Saint Lucie, FL 34952 | 2017-07-14 |
| Find all providers in zip 34952 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801318076 | Victoria Kustarz | Chiropractor | 456 Se Jupiter Ter, Port St Lucie, FL 34983-3212 | 2017-07-10 |
| 1235599689 | Madigan Family LLC | Chiropractor | 4098 Sw Balleto St, Port St Lucie, FL 34953-5382 | 2016-02-27 |
| 1942673223 | Tradition Family Chiropractic | Chiropractor | 10552 Sw Village Pkwy, Port St Lucie, FL 34987-2359 | 2015-11-09 |
| 1740660026 | Aaron Gajeske | Chiropractor | 7430 S Us Highway 1 Ste 7448, Port St Lucie, FL 34952 | 2015-06-02 |
| 1386034676 | Cox Chiropractic | Chiropractor | 625 Sw Jacoby Ave, Port St Lucie, FL 34953-3954 | 2015-01-26 |
| 1750787586 | Timothy Michael Kennedy | Chiropractor | 1680 Sw Saint Lucie West Blvd Ste 204, Port St Lucie, FL 34986 | 2014-11-05 |
| 1447673876 | Trena Marie Adams | Chiropractor | 111 Sw Chapman Ave, Port St Lucie, FL 34984-4310 | 2014-01-21 |
| 1346507837 | Central Palm Beach Physicians & Urgent Care Inc | Chiropractor | 1903 Port St. Lucie Blvd, Port St Lucie, FL 34952 | 2012-04-20 |
| 1548540651 | Amber Wehrle | Chiropractor | 10081 Sw Dolce Rd, Port St Lucie, FL 34986 | 2011-08-19 |
| 1326367269 | Victoria J Vislocky | Chiropractor | 149 Sw Port St Lucie Blvd, Port St Lucie, FL 34984-5017 | 2010-05-18 |
| Find all providers in PORT ST LUCIE | ||||
| City | PORT ST LUCIE |
| Zip Code | 34952 |
Please comment or provide details below to improve the information on DR. SHANE DONALD WHITELEY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.