NPIMap

Organization Active NPI

Whiteville Medical Clinic, LLC

  • Family Nurse Practitioner
  • Whiteville, TN
National Provider Identifier
1073754636
Registry record updated Mar 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
WHITEVILLE MEDICAL CLINIC, LLC
Practice address
2060 US Highway 64
Suite C
Whiteville, TN 38075-7476
Phone
(901) 626-6626
NPI assigned
Mar 11, 2009
Last updated
Mar 11, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2009

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

Authorized official

Name
Dee Blakney
Title
DNP
Phone
(901) 626-6626

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X
Family Nurse Practitioner 363LF0000X Primary

Addresses

Primary practice location

2060 US Highway 64
Suite C
Whiteville, TN 38075-7476

Mailing address

2060 US Highway 64
Suite C
Whiteville, TN 38075-7476

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1236729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236729600000",
    "number": "1073754636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 US HIGHWAY 64",
            "address_2": "SUITE C",
            "city": "WHITEVILLE",
            "state": "TN",
            "postal_code": "380757476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 US HIGHWAY 64",
            "address_2": "SUITE C",
            "city": "WHITEVILLE",
            "state": "TN",
            "postal_code": "380757476",
            "telephone_number": "901-626-6626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITEVILLE MEDICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-11",
        "last_updated": "2009-03-11",
        "status": "A",
        "authorized_official_last_name": "BLAKNEY",
        "authorized_official_first_name": "DEE",
        "authorized_official_title_or_position": "DNP",
        "authorized_official_telephone_number": "901-626-6626"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2009; 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.