WILLIE ROSCOE WHITAKER M.D. NPI 1861489759

NPI Information

  • NPI: 1861489759
  • Provider Name: WILLIE ROSCOE WHITAKER, M.D.
  • Classification: Internal Medicine - 207RN0300X
  • Specialization: Nephrology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2117 SIMONTON RD
    SUITE 102
    STATESVILLE, NC
    ZIP 28625
  • Phone: (704) 872-8422

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NPI Details

Willie Roscoe Whitaker, M.D. is a nephrology internal medicine in Statesville, NC with 50 years of experience. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. Willie Roscoe Whitaker, M.D. NPI is 1861489759. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: DUKE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:1976

The provider's business location address is:

2117 SIMONTON RD
SUITE 102
STATESVILLE, NC
ZIP 28625-403
Phone: (704) 872-8422
Fax: (704) 872-8705

The NPI 1861489759 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Dialysis services, 4 or more physician visits per month (20 years or older) (HCPCS:90960)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Hemodialysis procedure with physician evaluation (HCPCS:90935)
  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
  • Home dialysis services per month (20 years or older) (HCPCS:90966)
  • Dialysis services, 2-3 physician visits per month (20 years or older) (HCPCS:90961)
  • Urinalysis, manual test (HCPCS:81002)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Follow-up hospital inpatient care per day, typically 35 minutes (HCPCS:99233)

The enumeration date for this NPI number is 10/5/2005 and was last updated on 3/21/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal MedicineNC2003-00428NORTH CAROLINANo
2207RN0300XInternal MedicineNephrology2003-00428NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1134J6OTHERNORTH CAROLINABLUE CROSS BLUE SHIELD #
2C8620OTHERNORTH CAROLINAMEDCOST
33324386OTHERNORTH CAROLINACIGNA HEALTHCARE PROVIDER
489134J6MEDICAIDNORTH CAROLINA
5E73961OTHERUPIN
62013349MEDICARE ID-TYPE UNSPECIFIEDNORTH CAROLINAMEDICARE NUMBER
738354OTHERNORTH CAROLINAPARTNERS' MEDICARE #
8P00010140OTHERNORTH CAROLINARAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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