Individual provider Active NPI

Jennifer Justice White, PHARM.D.

  • Pharmacist
  • Cedar Bluff, VA
National Provider Identifier
1174617005
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
0202206219 Issued in VA
Practice address
810 Matney Rd
Cedar Bluff, VA 24609-8532
Phone
(276) 964-6668
Fax
(276) 963-9395
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 0202206219 VA Primary

Addresses

Primary practice location

810 Matney Rd
Cedar Bluff, VA 24609-8532

Mailing address

810 Matney Rd
Cedar Bluff, VA 24609-8532
Phone (276) 964-6668

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
0202206219VAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174617005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 MATNEY RD",
            "city": "CEDAR BLUFF",
            "state": "VA",
            "postal_code": "246098532",
            "telephone_number": "276-964-6668",
            "fax_number": "276-963-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 MATNEY RD",
            "city": "CEDAR BLUFF",
            "state": "VA",
            "postal_code": "246098532",
            "telephone_number": "276-964-6668",
            "fax_number": "276-963-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JENNIFER",
        "middle_name": "JUSTICE",
        "credential": "PHARM.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "VA",
            "license": "0202206219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Bluff, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.