HEATHER WHALEN APRN
NPI 1831600352
Nurse Practitioner - Family in Lexington, KY

Active since October 24, 2017PECOS EnrolledAccepts Medicare Assignment
95.5/100
CMS Quality Rating
3581 HARRODSBURG RD STE 125, LEXINGTON, KY 40513(859) 313-6200(859) 447-8936 Get Directions Write a Review

NPPES record last updated: June 10, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 10, 2024, Dec 10, 2020, Oct 24, 2017 (3 updates tracked since 2017).

About Heather Whalen Aprn NPPES

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

HEATHER WHALEN APRN (NPI 1831600352) is an individual family provider in Lexington, Kentucky, licensed in Kentucky (3011836) and active in the NPI registry since October 2017. She is enrolled in Medicare PECOS, maintains a secondary practice location in Berea, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1831600352
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameHEATHER WHALENCredential: APRN
Location Address3581 HARRODSBURG RD STE 125Lexington, KY 40513-1140
Mailing AddressPo Box 936London, KY 40743-0936 · (606) 330-7835 · Fax (606) 330-7825
Fax(859) 447-8936
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateOctober 24, 2017
Last NPPES UpdateJune 10, 20243 updates tracked since enumeration
NPPES CertifiedJune 10, 2024
NPI 1831600352 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in KY · 3011836
3581 HARRODSBURG RD STE 125, Lexington, KY 40513

Secondary Practice Location 1

Location 1120 Jill DrBerea, KY 40403-1677 · Phone (859) 985-7195 · Fax (859) 985-1001

Other Identifiers 1

Medicaid7100515600KY

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

Heather Whalen Aprn 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 ID840557245
PECOS Enrollment IDI20171120001034
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 10

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.

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.
118 services114 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.
58 services58 patients
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza 87428
This test uses a method called immunoassay to identify severe acute respiratory syndrome coronavirus and influenza. It works by detecting specific proteins (antigens) in a sample, like a nasal swab. It's a powerful tool in diagnosing these viral infections.
45 services44 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
33 services33 patients
Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 87880
A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.
26 services26 patients
X-ray of chest, 2 views 71046
A chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.
21 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40513 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

95.5/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality89.59
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 2

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

Nurse Practitioner
3581 HARRODSBURG RD STE 125
LEXINGTON, KY 40513
Nurse Practitioner (Family)
3581 HARRODSBURG RD STE 125
LEXINGTON, KY 40513

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 Heather Whalen's NPI number?

The NPI number for Heather Whalen is 1831600352. It was assigned to this individual provider in the NPPES registry on October 24, 2017.

Where is Heather Whalen located?

Heather Whalen practices at 3581 Harrodsburg Rd Ste 125, Lexington, KY 40513. The listed phone number is (859) 313-6200.

What is Heather Whalen's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Heather Whalen enrolled in Medicare?

Yes. Heather Whalen 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 Heather Whalen accept?

Health plans from CareSource list Heather Whalen 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.

When was this NPI record last updated?

The NPPES record for Heather Whalen was last updated on June 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.