Active NPI
Robin Wright Whitfield, ED.D.
- Clinical Psychologist
- Park Forest, IL
National Provider Identifier
1104930114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Practice address
- 230 Main St
Park Forest, IL 60466-2098 - Phone
- (404) 290-2731
- NPI assigned
- Aug 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | SS881 | FL | |
| Clinical Psychologist | 103TC0700X | IL | Primary |
Addresses
Primary practice location
230 Main St
Park Forest, IL 60466-2098
Mailing address
4509 Berringer Dr
Niceville, FL 32578-4259
Phone (404) 290-2731
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
| License | State | Type | Specialty |
|---|---|---|---|
| 071003885 | IL | MD | Clinical Psychologist |
| SS881 | FL | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155859200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205712000000",
"number": "1104930114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4509 BERRINGER DR",
"city": "NICEVILLE",
"state": "FL",
"postal_code": "325784259",
"telephone_number": "404-290-2731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "230 MAIN ST",
"city": "PARK FOREST",
"state": "IL",
"postal_code": "604662098",
"telephone_number": "404-290-2731"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITFIELD",
"first_name": "ROBIN",
"middle_name": "WRIGHT",
"name_prefix": "Dr.",
"credential": "ED.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-18",
"last_updated": "2008-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "FL",
"license": "SS881",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Park Forest, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.