Active NPI
Mary Whitmore, PA
- Physician Assistant
- Redding, CA
National Provider Identifier
1184644825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA18371
- Practice address
- 2175 Rosaline Ave
Redding, CA 96001-2509 - Phone
- (530) 225-6000
- Fax
- (818) 587-2493
- NPI assigned
- Jul 19, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA18371 | CA | Primary |
Addresses
Primary practice location
2175 Rosaline Ave
Redding, CA 96001-2509
Mailing address
PO Box 4419
Woodland Hills, CA 91365-4419
Phone (818) 340-9988
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN226059 | Medicaid | CA |
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18371 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1184644825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4419",
"city": "WOODLAND HILLS",
"state": "CA",
"postal_code": "913654419",
"telephone_number": "818-340-9988",
"fax_number": "818-587-2493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2175 ROSALINE AVE",
"city": "REDDING",
"state": "CA",
"postal_code": "960012509",
"telephone_number": "530-225-6000",
"fax_number": "818-587-2493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITMORE",
"first_name": "MARY",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA18371",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "RN226059",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Redding, CA
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.