Carol Manning Whitesides

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

197834-8900 Issued in UT

Practice address

1575 S State St
Salt Lake City, UT 84115-1610

Phone

(801) 957-3323

NPI assigned

Aug 25, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ms. Carol Manning Whitesides Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1219622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219622400000",
    "number": "1093962714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 WHITESIDES ST",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840414337",
            "telephone_number": "801-721-9914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1575 S STATE ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841151610",
            "telephone_number": "801-957-3323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITESIDES",
        "first_name": "CAROL",
        "middle_name": "MANNING",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-25",
        "last_updated": "2008-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "197834-8900",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "1978348900",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870532738005",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "WHITESIDES",
            "middle_name": "MANNING",
            "prefix": "MS.",
            "credential": "FNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jennifer Anne Whitehead, PHYSICIAN ASSISTANT
• Kevin John Whitehead, MD
• Rylee Jade Whitehouse, PA-C
• Sandra Louise Whitehouse, PH.D.
• Cher'Re Whitelaw
• Jacob Whiting
• Jared Whiting
• Rachelle Whiting
• Ryan Eric Whiting, MD
• Stephanie Whiting

• Family Nurse Practitioner in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2008; 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.