Individual provider Active NPI

Pamela S Whitley, FNP-BC, CWOCN

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1225229073
Registry record updated Jun 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
201510 Issued in NC
Practice address
300 Billingsley Rd
Suite 105
Charlotte, NC 28211-1075
Phone
(704) 384-4098
Fax
(704) 384-5743
NPI assigned
Aug 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201510 NC
Nurse Practitioner 363L00000X 201510 NC Primary

Addresses

Primary practice location

300 Billingsley Rd
Suite 105
Charlotte, NC 28211-1075

Mailing address

PO Box 601529
Charlotte, NC 28260-1529
Phone (704) 384-4098

Other identifiers 1

IdentifierTypeStateIssuer
7000232MedicaidNC

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
201510NCMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371772800000",
    "number": "1225229073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 601529",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282601529",
            "telephone_number": "704-384-4098",
            "fax_number": "704-384-5743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BILLINGSLEY RD",
            "address_2": "SUITE 105",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111075",
            "telephone_number": "704-384-4098",
            "fax_number": "704-384-5743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLEY",
        "first_name": "PAMELA",
        "middle_name": "S",
        "credential": "FNP-BC, CWOCN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-07",
        "last_updated": "2013-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "201510",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "201510",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7000232",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 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.