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JAKE ARTHUR WHITESIDE
NPI 1790480200
Student in an Organized Health Care Education/Training Program in Dayton, OH

Active since April 03, 2023PECOS Enrolled
30 E APPLE ST STE 6258, DAYTON, OH 45409(937) 208-2951 Get Directions Write a Review

NPPES record last updated: February 2, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 2, 2026, Apr 3, 2023 (2 updates tracked since 2023).

About Jake Arthur Whiteside NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAKE ARTHUR WHITESIDE (NPI 1790480200) is an individual student in an organized health care education/training program in Dayton, Ohio, licensed in Indiana (01096565A) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1790480200
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJAKE ARTHUR WHITESIDE
Location Address30 E APPLE ST STE 6258Dayton, OH 45409-2939
Mailing Address30 E Apple St Ste 6258Dayton, OH 45409-2939
Phone(937) 208-2951
Sole ProprietorNo
Enumeration DateApril 3, 2023
Last NPPES UpdateFebruary 2, 20262 updates tracked since enumeration
NPPES CertifiedFebruary 2, 2026
✔ NPI 1790480200 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in IN · 01096565A
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
30 E APPLE ST STE 6258, Dayton, OH 45409
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jake Arthur Whiteside is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. NGA TRAN DO
Student in an Organized Health Care Education/Training Program
30 E APPLE ST STE 6258
DAYTON, OH 45409
Montgomery County (937) 208-8000
EVAN BRANDENBURG
Student in an Organized Health Care Education/Training Program
30 E APPLE ST STE 6258
DAYTON, OH 45409
Montgomery County (937) 208-8000
AUSTIN RAY NELSON MD
Student in an Organized Health Care Education/Training Program
30 E APPLE ST STE 6258
DAYTON, OH 45409
Montgomery County (937) 208-2951
NICHOLAS AARON BURPEE MD
Student in an Organized Health Care Education/Training Program
30 E APPLE ST STE 6258
DAYTON, OH 45409
Montgomery County (937) 208-8000
AKMAL SALAM
Student in an Organized Health Care Education/Training Program
30 E APPLE ST STE 6258
DAYTON, OH 45409
Montgomery County (937) 208-8000
DR. GREGORY R. SEMON D.O.
Surgery
30 E APPLE ST STE 6258
DAYTON, OH 45409
Montgomery County (937) 208-5055
JASON CHRISTOPHER PRADARELLI MD, MS
Surgery
30 E APPLE ST STE 6258
DAYTON, OH 45409
Montgomery County (937) 208-8000
DR. CHEYENNE NICOLE WONG DO
Student in an Organized Health Care Education/Training Program
30 E APPLE ST STE 6258
DAYTON, OH 45409
Montgomery County (937) 208-8000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jake Whiteside's NPI number?

The NPI number for Jake Whiteside is 1790480200. It was assigned to this individual provider in the NPPES registry on April 3, 2023.

Where is Jake Whiteside located?

Jake Whiteside practices at 30 E Apple St Ste 6258, Dayton, OH 45409. The listed phone number is (937) 208-2951.

What is Jake Whiteside's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jake Whiteside enrolled in Medicare?

Yes. Jake Whiteside is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jake Whiteside was last updated on February 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.