Individual provider Active NPI

Patricia Diane Whitt, PH.D.

  • Clinical Psychologist
  • Davidson, NC
National Provider Identifier
1063491884
Registry record updated Apr 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1823 Issued in NC
Practice address
903 Northeast Dr Ste 101
Davidson, NC 28036-7437
Phone
(704) 896-6068
NPI assigned
Jan 11, 2006
Last updated
Apr 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1823 NC Primary

Addresses

Primary practice location

903 Northeast Dr Ste 101
Davidson, NC 28036-7437

Mailing address

903 Northeast Dr Ste 101
Davidson, NC 28036-7437
Phone (704) 896-6068

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041103000616 NC Practitioner - Clinical Psychologist 0143282939 Practice locations: Davidson, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

903 Northeast Dr
Suite 101
Davidson, NC 28036-7437
Phone (704) 896-6068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1823NCMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1063491884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 NORTHEAST DR STE 101",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280367437",
            "telephone_number": "704-896-6068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 NORTHEAST DR STE 101",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280367437",
            "telephone_number": "704-896-6068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITT",
        "first_name": "PATRICIA",
        "middle_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-11",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "1823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davidson, NC

Sources for this page

Verify at the official NPI Registry.