Individual provider Active NPI

Sara R White, NP

  • Nurse Practitioner
  • Matthews, NC
National Provider Identifier
1184696106
Registry record updated Feb 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
200395 Issued in NC
Practice address
1401 Matthews Township Pkwy
Suite 200
Matthews, NC 28105-5402
Phone
(704) 384-6901
Fax
(704) 384-6902
NPI assigned
Feb 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 200395 NC Primary

Addresses

Primary practice location

1401 Matthews Township Pkwy
Suite 200
Matthews, NC 28105-5402

Mailing address

PO Box 60447
Charlotte, NC 28260-0447
Phone (704) 384-6901

Other identifiers 1

IdentifierTypeStateIssuer
7005357MedicaidNC

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
200395NCMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360886400000",
    "number": "1184696106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-6901",
            "fax_number": "704-384-6902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MATTHEWS TOWNSHIP PKWY",
            "address_2": "SUITE 200",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281055402",
            "telephone_number": "704-384-6901",
            "fax_number": "704-384-6902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "SARA",
        "middle_name": "R",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-03",
        "last_updated": "2013-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "200395",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7005357",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2013; 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.