Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Corey Michael Whitesides, PA-C

Individual provider Medical Physician Assistant · NPI 1689019614

Corey Michael Whitesides, PA-C is a Physician Assistant in Kansas City, Missouri. Qualified in 2013, 13 years ago. Practices with Central Missouri Dermatology Associates, LLP, a 15-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
13
Licensed in
MO
In the registry since
2013
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2790 Clay Edwards Dr Ste 600
Kansas City, MO 64116-3276
Phone: (816) 561-3003
Fax: (816) 889-1584
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 2013013231 (MO)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 2013013231 (MO)

Record details

NPI number1689019614
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 3, 2013
Last updated in NPPESMay 3, 2013

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Central Missouri Dermatology Associates, Llp — 15 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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