Active NPI
Samantha Wholley, MPH, RD, LD
- Registered Dietitian
- Tampa, FL
National Provider Identifier
1053998641
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- ND9146
- Practice address
- 1512 E 12TH Ave Unit 403
Tampa, FL 33605-3578 - Phone
- (603) 475-8531
- NPI assigned
- Mar 28, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | ND9146 | FL | Primary |
Addresses
Primary practice location
1512 E 12TH Ave Unit 403
Tampa, FL 33605-3578
Mailing address
1512 E 12TH Ave Unit 403
Tampa, FL 33605-3578
Phone (603) 475-8531
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
| License | State | Type | Specialty |
|---|---|---|---|
| ND9146 | FL | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616889600000",
"number": "1053998641",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1512 E 12TH AVE UNIT 403",
"city": "TAMPA",
"state": "FL",
"postal_code": "336053578",
"telephone_number": "603-475-8531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1512 E 12TH AVE UNIT 403",
"city": "TAMPA",
"state": "FL",
"postal_code": "336053578",
"telephone_number": "603-475-8531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHOLLEY",
"first_name": "SAMANTHA",
"name_prefix": "Ms.",
"credential": "MPH, RD, LD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-03-28",
"last_updated": "2021-03-28",
"certification_date": "2021-03-28",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dietitian, Registered",
"state": "FL",
"license": "ND9146",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tampa, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.