Shaketa Dion Whitaker, FNP-C is a medicare enrolled "Nurse Practitioner - Family" physician in Tarboro, North Carolina. Her current practice location is
101 Clinic Dr, Tarboro, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(252) 823-6221.
Shaketa Dion Whitaker is licensed to practice in North Carolina (license number 5015216) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1588230007.
Physician's Profile
| Full Name | Shaketa Dion Whitaker |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 101 Clinic Dr, Tarboro, North Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1588230007
- Provider Enumeration Date: 06/03/2021
- Last Update Date: 10/22/2024
Medicare PECOS Information:
- PECOS PAC ID: 4183013683
- Enrollment ID: I20211122001413
Medical Identifiers
Medical identifiers for Shaketa Dion Whitaker such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1588230007 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207QA0505X | Family Medicine - Adult Medicine | F05210015 (North Carolina) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 5015216 (North Carolina) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Shaketa Dion Whitaker allows following entities to bill medicare on her behalf.
| Entity Name | Vidant Medical Group Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1477648731 PECOS PAC ID: 0345343893 Enrollment ID: O20070321000445 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shaketa Dion Whitaker is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Shaketa Dion Whitaker, FNP-C Po Box 751069, Charlotte, NC 28275-1069 Ph: () - | Shaketa Dion Whitaker, FNP-C 101 Clinic Dr, Tarboro, NC 27886-1935 Ph: (252) 823-6221 |
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