Thomas Lee Whitehead Jr., FNP-C
Nurse Practitioner in Brawley, CA. Individual provider (NPI-1).
NPI number1982122560
StatusActive
Last updated in NPPESSep 5, 2017
Details
- NPI
- 1982122560
- Entity type
- Individual (NPI-1)
- Name
- Thomas Lee Whitehead Jr.
- Credential
- FNP-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 5, 2017
- Last updated
- Sep 5, 2017
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 95007261 | CA | Yes |
Practice location
207 W Legion RdBrawley, CA 92227-7780
Phone 760-351-3130 · Fax 760-351-3130
Mailing address
2555 Valle Verde LnImperial, CA 92251-8003
Phone 769-960-2376
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 11 Nurse Practitioner providers in Brawley · All 439 providers in Brawley
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