THOMAS LEE WHITEHEAD JR. (NPI# 1982122560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982122560 |
| Entity Type | Individual |
| Full Name | THOMAS LEE WHITEHEAD JR. |
| Credential | FNP-C |
| Practice Address |
207 W Legion Rd Brawley CA 92227-7780 |
| Mailing Address |
2555 Valle Verde Ln Imperial CA 92251-8003 |
| Practice Telephone | 7603513130 |
| Practice Fax Number | 7603513130 |
| Mailing Telephone | 7699602376 |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2017-09-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 95007261 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205843687 | Thomas O. Whitehead | Counselor | 502 Depot St, El Campo, TX 77437-3323 | 2006-08-01 |
| 1518912740 | Thomas Alexander Whitehead | Radiology | 1800 Hospital South Dr, Austell, GA 30106-8114 | 2006-05-24 |
| 1962512772 | Thomas B Whitehead | Family Medicine | 502 Broad St, Columbia, MS 39429-3037 | 2006-08-30 |
| Street Address |
207 W LEGION RD |
| City | BRAWLEY |
| State | CA |
| Zip Code | 92227-7780 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073519443 | Pioneers Memorial Healthcare District | General Acute Care Hospital | 207 W Legion Rd, Brawley, CA 92227-7780 | 2005-06-21 |
| 1174161251 | Richard Jacoby Md Inc | Internal Medicine | 207 W Legion Rd, Brawley, CA 92227-7780 | 2019-12-19 |
| 1558908368 | Joe Anthony Gonzales Jr. | Nurse Practitioner | 207 W Legion Rd, Brawley, CA 92227-7780 | 2019-11-30 |
| 1275177370 | Natalia Babkina Md Phd Inc | Obstetrics & Gynecology | 207 W Legion Rd, Brawley, CA 92227-7780 | 2019-10-31 |
| 1497300628 | Basso-williams 11 Blade of California, PC | Orthopaedic Surgery | 207 W Legion Rd, Brawley, CA 92227-7780 | 2019-08-05 |
| 1083272025 | Laurel Crismon Popplewell | Physician Assistant | 207 W Legion Rd, Brawley, CA 92227-7780 | 2019-06-04 |
| 1962977561 | Michael Bux | Specialist/Technologist | 207 W Legion Rd, Brawley, CA 92227-7780 | 2018-10-10 |
| 1316446644 | Imperial Valley Hospitalist Inc | Internal Medicine | 207 W Legion Rd, Brawley, CA 92227-7780 | 2018-02-01 |
| 1457870727 | Matthew Petro | Physician Assistant | 207 W Legion Rd, Brawley, CA 92227-7780 | 2017-09-18 |
| 1356863997 | Trang Vo | Physician Assistant | 207 W Legion Rd, Brawley, CA 92227-7780 | 2017-07-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548755283 | Imperial Valleyrespite, Inc. | Behavioral Analyst | 630 S. Imperial Ave., Ste. 2, Brawley, CA 92227 | 2018-06-26 |
| 1013424704 | Denise Vizcarra | Behavior Technician | 630 S Brawley Ave Ste 2, Brawley, CA 92227 | 2018-01-04 |
| 1831465178 | Marylou Cayetano Thelmo | Obstetrics & Gynecology | 1166 K Street, Brawley, CA 92227 | 2012-03-30 |
| 1396046983 | Dominga Marquez De Vera | Pharmacist | 475 West Main Street, Vons Pharmacy, Brawley, CA 92227 | 2010-11-12 |
| 1033441795 | Marshall Ray Debruler | Physician Assistant | 207 W. Legion Rd, Brawley, CA 92227 | 2010-02-05 |
| 1073758280 | Brawley Physical Therapy | Clinic/Center | 529 E Street, Brawley, CA 92227 | 2008-12-03 |
| 1609058924 | Leticia Bustamante | Nurse Practitioner | 751 West Legion Road, Suite 102, Brawley, CA 92227 | 2007-11-28 |
| 1073701504 | Imperial County Behavioral Health Services | Clinic/Center | 385 D St Rm 30, Brawley, CA 92227 | 2007-10-10 |
| 1013118801 | Joseph Kurt Bivens | Plastic Surgery | 751 W Legion Rd Ste 300, Brawley, CA 92227 | 2007-05-30 |
| 1083771489 | Yong Tan | Family Medicine | 751 West Legion Road, Suite 102, Brawley, CA 92227 | 2007-01-03 |
| Find all providers in zip 92227 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609058924 | Leticia Bustamante | Nurse Practitioner | 751 West Legion Road, Suite 102, Brawley, CA 92227 | 2007-11-28 |
| 1275550709 | Richard Fitzsimmons | Nurse Practitioner | 125 South 5th St, Brawley, CA 92227 | 2006-07-17 |
| 1003840174 | Mary Kay Klockmann | Nurse Practitioner | 608 G Street, Brawley, Brawley, CA 92227-2567 | 2006-07-11 |
| 1407325582 | Arnold Samuel Castro Jr. | Nurse Practitioner | 751 W Legion Rd Ste 103, Brawley, CA 92227-7754 | 2018-11-18 |
| 1437664729 | Rosanna Salgado Pritting | Nurse Practitioner | 751 W Legion Rd Ste 103, Brawley, CA 92227-7754 | 2017-12-08 |
| 1861926198 | Talia Luc | Nurse Practitioner | 900 Main Street, Brawley, CA 92227-2737 | 2017-04-13 |
| 1538608856 | Noemi Diaz Esparza | Nurse Practitioner | 751 W Legion Rd Ste 103, Brawley, CA 92227-7754 | 2017-02-20 |
| 1497148688 | Isioma Utebor | Nurse Practitioner | 900 Main St, Brawley, CA 92227-2630 | 2015-03-11 |
| 1306117619 | Emilia Beas | Nurse Practitioner | 1166 K St, Brawley, CA 92227-2737 | 2012-01-18 |
| 1932332608 | Kimberly Calderon | Nurse Practitioner | 1166 K St, Brawley, CA 92227-2737 | 2009-08-28 |
| Find all providers in BRAWLEY | ||||
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| 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.