THEODORE M. WHITAKER (DO) – Internal Medicine Physician, NPI 1164413167

THEODORE M. WHITAKER (DO) is a healthcare provider. based in Overland park, Kansas. specializing in Internal Medicine Physician. They hold the professional credentials DO. They hold a License No. R1D87 (MO). The NPI Number for THEODORE M. WHITAKER (DO) is 1164413167

Main info

Male
46 Years Of Experience
Accepts Medicare Assignment
Name
THEODORE M. WHITAKER (DO)
NPI
1164413167
Phone
(816) 943-0406
Address
12140 NALL AVE STE 100
Enumeration Date
31 October 2005
Last Update Date
17 March 2018

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8169430706
Graduation Year
1980 (46 years ago)
PAC ID
5698805950
Group Practice PAC ID
0042335044
Professional Enrollment ID
I20151116000101
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for THEODORE M. WHITAKER (DO)

  • Nall Avenue, Overland Park, Johnson County, Kansas, 66085, United States

    OVERLAND PARK, KS 662092504

    Phone: (816) 943-0406

    Fax: (913) 451-1754

    Type: Mailing

  • 6420 Prospect Avenue

    Suite T101

    Kansas City, MO 641321186

    Phone: (816) 363-4100

    Fax: (816) 363-8201

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 66209)

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Provider's Procedures

THEODORE M. WHITAKER (DO) performs procedures in Internal Medicine Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEMO83036Hemoglobin A1C level382240

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0042335044View full group profile
NameSpecialtyState
DR. JOHN GOLDBERG (M.D.)
-KS
DR. MICHAEL SOKOL (MD)
Internal Medicine, PsychiatryKS
PANDURANG P CHILLAL (M.D.)
Internal MedicineKS
DAVID A WILT (MD)
-KS
GARRETT WILT (DO)
Internal MedicineIA
MR. PETER F ALFANO (PA)
-KS
DR. NIDAL BOUTROS
Internal MedicineMO
AMIR HEMAYA (MD)
-KS
DR. SHARON SNAVELY (MD)
-KS

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Frequently asked questions

Can I cross-check THEODORE M. WHITAKER (DO) using NPI 1164413167?
NPI 1164413167 belongs to THEODORE M. WHITAKER (DO); compare other details if you need extra assurance.
Would THEODORE M. WHITAKER (DO) appear as active to a payer?
You can treat THEODORE M. WHITAKER (DO) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with THEODORE M. WHITAKER (DO)?
THEODORE M. WHITAKER (DO)'s record emphasizes Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Where in Kansas is THEODORE M. WHITAKER (DO) registered?
Use Overland Park, Kansas as the headline location for THEODORE M. WHITAKER (DO) here.
Does THEODORE M. WHITAKER (DO) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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