Individual provider Active NPI

Junie White

  • Adult Health Nurse Practitioner
  • Jamaica, NY
National Provider Identifier
1124338520
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F307491 Issued in NY
Practice address
17617 130TH Ave
Jamaica, NY 11434-5823
Phone
(917) 502-4262
NPI assigned
Oct 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 599878-1 NY
Adult Health Nurse Practitioner 363LA2200X F307491 NY Primary

Addresses

Primary practice location

17617 130TH Ave
Jamaica, NY 11434-5823

Mailing address

17617 130TH Ave
Jamaica, NY 11434-5823
Phone (917) 502-4262

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
599878-1NYMDSchool Registered Nurse
F307491NYMDAdult Health Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1124338520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17617 130TH AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114345823",
            "telephone_number": "917-502-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17617 130TH AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114345823",
            "telephone_number": "917-502-4262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JUNIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-19",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WS0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, School",
            "state": "NY",
            "license": "599878-1",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F307491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2021; 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.