Demetrius Whitehead, LPN is a
Residential Treatment Facility, Physical Disabilities based in Indianapolis, Indiana. Demetrius Whitehead is licensed to practice in Indiana (license number 21015321) and his current practice location is
415 S Butler Ave, Indianapolis, Indiana. He can be reached at his office (for appointments etc.) via phone at
(317) 499-0437.
NPI number for Demetrius Whitehead is 1346880341 and his current mailing address is 415 S Butler Ave, Indianapolis, Indiana. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1346880341.
Provider's Profile
Full Name | Demetrius Whitehead |
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Gender | Male |
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Speciality | Residential Treatment Facility, Physical Disabilities |
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Location | 415 S Butler Ave, Indianapolis, Indiana |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1346880341
- Provider Enumeration Date: 01/08/2020
- Last Update Date: 02/28/2024
Medical Identifiers
Medical identifiers for Demetrius Whitehead such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1346880341 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
164W00000X | Licensed Practical Nurse | 27060564A (Indiana) | Secondary |
320600000X | Residential Treatment Facility, Intellectual And/or Developmental Disabilities | 21015321 (Indiana) | Secondary |
320700000X | Residential Treatment Facility, Physical Disabilities | 21015321 (Indiana) | Primary |
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. Demetrius Whitehead is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Demetrius Whitehead, LPN 415 S Butler Ave, Indianapolis, IN 46219-7034 Ph: (317) 409-1422 | Demetrius Whitehead, LPN 415 S Butler Ave, Indianapolis, IN 46219-7034 Ph: (317) 499-0437 |
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