Individual provider Active NPI

Mary Michelle Whited

  • Registered Nurse
  • Hillsboro, OH
National Provider Identifier
1104089846
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN. 338442 Issued in OH
Practice address
9963 Coss Rd
Hillsboro, OH 45133-6625
Phone
(937) 764-1321
NPI assigned
Jul 2, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN. 338442 OH Primary

Addresses

Primary practice location

9963 Coss Rd
Hillsboro, OH 45133-6625

Mailing address

9963 Coss Rd
Hillsboro, OH 45133-6625
Phone (937) 764-1321

Other names 1

  • Mary Michelle Smith Former name

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
RN. 338442OHMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1104089846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9963 COSS RD",
            "city": "HILLSBORO",
            "state": "OH",
            "postal_code": "451336625",
            "telephone_number": "937-764-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9963 COSS RD",
            "city": "HILLSBORO",
            "state": "OH",
            "postal_code": "451336625",
            "telephone_number": "937-764-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITED",
        "first_name": "MARY",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-02",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN. 338442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "SMITH",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hillsboro, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.