THOMAS F WHEALTON DO
NPI 1811254105
Anesthesiology - Pain Medicine in Corbin, KY

Active since April 12, 2012PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
1498 W CUMBERLAND GAP PKWY, CORBIN, KY 40701(606) 280-7875 Get Directions Write a Review

NPPES record last updated: September 6, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Sep 6, 2024, Sep 19, 2022, Aug 15, 2022 and 3 more (6 updates tracked since 2017).

About Thomas F Whealton Do NPPES

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

THOMAS F WHEALTON DO (NPI 1811254105) is an individual pain medicine provider in Corbin, Kentucky, licensed in Kentucky (04206) and active in the NPI registry since April 2012. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Richmond, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1811254105
Entity TypeIndividualMale
Primary Taxonomy207LP2900X
Provider Legal NameTHOMAS F WHEALTONCredential: DO
Location Address1498 W CUMBERLAND GAP PKWYCorbin, KY 40701-5902
Mailing Address1498 W Cumberland Gap PkwyCorbin, KY 40701-5902 · (606) 280-7875 · Fax (833) 974-2501
Sole ProprietorNo
Medical School CMSAt Still University Of Health Sciences, College Of Osteo Med, KirksvilleGraduated 2012
Enumeration DateApril 12, 2012
Last NPPES UpdateSeptember 6, 20246 updates tracked since enumeration
NPPES CertifiedSeptember 6, 2024
NPI 1811254105 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyAnesthesiology · Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207LP2900X
Licenses Licensed in KY · 04206 Licensed in KY · TP992
Definition
An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists.
1498 W CUMBERLAND GAP PKWY, Corbin, KY 40701

Secondary Practice Locations 2

Location 11018 Ival James BlvdRichmond, KY 40475-8280 · Phone (859) 544-1068
Location 2920 Barnes Mill Rd Ste ARichmond, KY 40475-3539 · Phone (859) 544-1068

Other Identifiers 1

Medicaid7100500430KY

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Thomas F Whealton Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9234430158
PECOS Enrollment IDI20170719001463
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.

Areas of Expertise CMS Part B claims 27

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Professional service for preparation and provision of 1 or more antigens 95165
This service involves the creation and supply of antigens, substances that stimulate your immune system to fight diseases. These antigens can be used in vaccines or allergy tests to help your body build defenses against specific health threats.
3,220 services13 patients
Test for allergy using allergenic extract 95004
An allergy test with allergenic extract is a diagnostic method to identify substances causing allergic reactions. Small amounts of common allergens are introduced to your body, usually through skin pricks or blood tests. Your body's response helps determine your allergies.
2,160 services30 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
933 services289 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
855 services282 patients
Testing for presence of drug, by chemistry analyzers 80307
Chemistry analyzers are used to detect the presence of drugs in your system. This test involves taking a small sample of your blood or urine. The sample is then analyzed for specific substances. The results help in understanding your health condition better.
643 services258 patients
Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490
Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.
356 services81 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Baptist Health Richmond

Acute Care Hospitals · Richmond, KY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180049
Location801 Eastern BypassRichmond, KY 40475 · Madison County
Emergency services Birthing friendly

Baptist Health Corbin

Acute Care Hospitals · Corbin, KY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number180080
LocationOne Trillium WayCorbin, KY 40701 · Whitley County
Emergency services Birthing friendly

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
92%1,047 patients3/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
8%142 patients1/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
99%1,076 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
14%4,184 patients1/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
41%4,184 patients2/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
6%4,184 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
41%4,184 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf L0650
DME-Orthotic Devices · category DF007N
1 supplier19 claims19 services$901.92 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 10

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

Physician Assistant
1498 W CUMBERLAND GAP PKWY
CORBIN, KY 40701
Nurse Practitioner
1498 W CUMBERLAND GAP PKWY
CORBIN, KY 40701
Nurse Practitioner (Family)
1498 W CUMBERLAND GAP PKWY
CORBIN, KY 40701
Anesthesiology (Pain Medicine)
1498 W CUMBERLAND GAP PKWY
CORBIN, KY 40701
Nurse Practitioner (Family)
1498 W CUMBERLAND GAP PKWY
CORBIN, KY 40701
Nurse Practitioner (Family)
1498 W CUMBERLAND GAP PKWY
CORBIN, KY 40701
Anesthesiology (Pain Medicine)
1498 W CUMBERLAND GAP PKWY
CORBIN, KY 40701
Physician Assistant
1498 W CUMBERLAND GAP PKWY
CORBIN, KY 40701

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 Thomas Whealton's NPI number?

The NPI number for Thomas Whealton is 1811254105. It was assigned to this individual provider in the NPPES registry on April 12, 2012.

Where is Thomas Whealton located?

Thomas Whealton practices at 1498 W Cumberland Gap Pkwy, Corbin, KY 40701. The listed phone number is (606) 280-7875.

What is Thomas Whealton's specialty?

The primary specialty registered for this NPI is Anesthesiology, specializing in Pain Medicine, with taxonomy code 207LP2900X.

Is Thomas Whealton enrolled in Medicare?

Yes. Thomas Whealton is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Thomas Whealton accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter of Tennessee and CareSource list Thomas Whealton as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Thomas Whealton affiliated with any hospitals?

According to CMS data, Thomas Whealton is affiliated with Baptist Health Richmond and Baptist Health Corbin.

When was this NPI record last updated?

The NPPES record for Thomas Whealton was last updated on September 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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.