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WILLIE ROSCOE WHITAKER M.D.
NPI 1861489759
Internal Medicine - Nephrology in Statesville, NC

Active since October 05, 2005PECOS EnrolledAccepts Medicare Assignment
2117 SIMONTON RD, SUITE 102, STATESVILLE, NC 28625(704) 872-8422(704) 872-8705 Get Directions Write a Review

NPPES record last updated: March 21, 2014. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Willie Roscoe Whitaker M.d. NPPES

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

WILLIE ROSCOE WHITAKER M.D. (NPI 1861489759) is an individual nephrology provider in Statesville, North Carolina, licensed in North Carolina (2003-00428) and active in the NPI registry since October 2005. He is enrolled in Medicare PECOS, is affiliated with Iredell Memorial Hospital Inc, and is a graduate of Duke University School Of Medicine (1976).

NPPES Registry Identity

NPI1861489759
Entity TypeIndividualMale
Primary Taxonomy207RN0300X
Provider Legal NameWILLIE ROSCOE WHITAKERCredential: M.D.
Location Address2117 SIMONTON RD, SUITE 102Statesville, NC 28625-8403
Mailing Address2117 Simonton Rd, Suite 102Statesville, NC 28625-8403 · (704) 872-8422 · Fax (704) 872-8705
Phone(704) 872-8422
Fax(704) 872-8705
Sole ProprietorYes
Medical School CMSDuke University School Of MedicineGraduated 1976
Enumeration DateOctober 5, 2005
Last NPPES UpdateMarch 21, 2014
✔ NPI 1861489759 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
License✔ Licensed in NC · 2003-00428
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
Also ListedInternal MedicineTaxonomy 207R00000X · License NC2003-00428 (NC)
2117 SIMONTON RD, Statesville, NC 28625
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Other Identifiers 8

Other134J6NC · Blue Cross Blue Shield #
OtherC8620NC · Medcost
Other3324386NC · Cigna Healthcare Provider
Medicaid89134J6NC
OtherE73961Upin
Medicare ID-Type Unspecified2013349NC · Medicare Number
Other38354NC · Partners' Medicare #
OtherP00010140NC · Railroad Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, UnitedHealthcare.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

Willie Roscoe Whitaker M.d. 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 ID345133955
PECOS Enrollment IDI20080813000337
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 7

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 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.
107 services62 patients
Dialysis services, 4 or more physician visits per month (20 years or older) 90960
Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.
93 services18 patients
Dialysis services, 2-3 physician visits per month (20 years or older) 90961
Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.
53 services17 patients
Hemodialysis procedure with physician evaluation 90935
Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.
47 services14 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
47 services19 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
16 services13 patients

Hospital Affiliations CMS Care Compare 2

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

Iredell Memorial Hospital Inc

Acute Care Hospitals · Statesville, NC
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340039
Location557 Brookdale DrStatesville, NC 28677 · Iredell County
Emergency services Birthing friendly

North Carolina Baptist Hospital

Acute Care Hospitals · Winston-Salem, NC
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340047
LocationMedical Center BoulevardWinston-Salem, NC 27157 · Forsyth County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 28625 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
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
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.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
99%146 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
88%168 patients4/55-star benchmark: 100%
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 6

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

Cyclosporine, oral, 100 mg J7502
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier12 claims720 services$1.70 avg. paid by Medicare
Prednisone, immediate release or delayed release, oral, 1 mg J7512
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier12 claims1,800 services$0.01 avg. paid by Medicare
Cyclosporine, oral, 25 mg J7515
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier12 claims360 services$0.60 avg. paid by Medicare
Mycophenolate mofetil, oral, 250 mg J7517
Treatment-Treatment - Miscellaneous · category RX029N
1 supplier12 claims1,440 services$0.20 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for the first prescription in a 30-day period Q0511
Treatment-Chemotherapy · category RH012N
1 supplier22 claims22 services$18.95 avg. paid by Medicare
Pharmacy supply fee for oral anti-cancer, oral anti-emetic or immunosuppressive drug(s); for a subsequent prescription in a 30-day period Q0512
Treatment-Chemotherapy · category RH012N
1 supplier46 claims46 services$12.63 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 4

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

MICHAEL BORJA MD
Pediatrics
2117 SIMONTON RD, SUITE 402
STATESVILLE, NC 28625
Iredell County (704) 871-2323
NORTHLAKE PEDIATRIC CARE PA
Pediatrics
2117 SIMONTON RD, SUITE 402
STATESVILLE, NC 28625
Iredell County (704) 871-2323
DR. PERRY STEPHEN JUSTICE JR. D.D.S.
Dentist (General Practice)
2117 SIMONTON RD, SUITE 403
STATESVILLE, NC 28625
Iredell County (704) 873-8899
PERRY S JUSTICE JR DDS PA
Dentist (General Practice)
2117 SIMONTON RD, SUITE 403
STATESVILLE, NC 28625
Iredell County (704) 873-8899

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 Willie Whitaker's NPI number?

The NPI number for Willie Whitaker is 1861489759. It was assigned to this individual provider in the NPPES registry on October 5, 2005.

Where is Willie Whitaker located?

Willie Whitaker practices at 2117 Simonton Rd Suite 102, Statesville, NC 28625. The listed phone number is (704) 872-8422.

What is Willie Whitaker's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Willie Whitaker enrolled in Medicare?

Yes. Willie Whitaker 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 Willie Whitaker accept?

Health plans from Blue Cross and Blue Shield of NC and UnitedHealthcare list Willie Whitaker 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 Willie Whitaker affiliated with any hospitals?

According to CMS data, Willie Whitaker is affiliated with Iredell Memorial Hospital Inc and North Carolina Baptist Hospital.

When was this NPI record last updated?

The NPPES record for Willie Whitaker was last updated on March 21, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.