Individual provider Active NPI

Samantha Wholley, MPH, RD, LD

  • Registered Dietitian
  • Tampa, FL
National Provider Identifier
1053998641
Registry record updated Mar 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
ND9146 Issued in FL
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

Updated by the provider on Mar 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 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

LicenseStateTypeSpecialty
ND9146FLMDRegistered 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.

Verify at the official NPI Registry.