Individual provider Active NPI

Robert Montgomery Whiten

  • Pharmacist
  • Port Saint Lucie, FL
National Provider Identifier
1013500958
Registry record updated Feb 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS60701 Issued in FL
Practice address
127 NE Royce Ave
Port Saint Lucie, FL 34983-1238
Phone
(770) 310-6721
NPI assigned
Feb 11, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 11, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Pharmacist 1835P0200X PS60701 FL
Pharmacist 183500000X PS60701 FL Primary

Addresses

Primary practice location

127 NE Royce Ave
Port Saint Lucie, FL 34983-1238

Mailing address

127 NE Royce Ave
Port Saint Lucie, FL 34983-1238
Phone (770) 310-6721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PS60701FLMDPediatric Pharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1013500958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 NE ROYCE AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349831238",
            "telephone_number": "770-310-6721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 NE ROYCE AVE",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349831238",
            "telephone_number": "770-310-6721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEN",
        "first_name": "ROBERT",
        "middle_name": "MONTGOMERY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pediatrics",
            "state": "FL",
            "license": "PS60701",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS60701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Saint Lucie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.