Active NPI
Gina Rochelle Whitehead, DNP, FNP
- Family Nurse Practitioner
- Hattiesburg, MS
National Provider Identifier
1245795657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 903173
- Practice address
- 415 S 28TH Ave
Hattiesburg, MS 39401-7246 - Phone
- (601) 268-5800
- Fax
- (601) 261-3530
- NPI assigned
- Feb 10, 2019
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 903173 | MS | |
| Family Nurse Practitioner | 363LF0000X | 903173 | MS | Primary |
Addresses
Primary practice location
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Mailing address
415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 268-5800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08971821 | Medicaid | MS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | gwhitehead84219@directpatientrecord.com | Health Information Exchange (HIE) |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 903173 | MS | MD | Nurse Practitioner |
Interoperability endpoints
- gwhitehead84219@directpatientrecord.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596067200000",
"number": "1245795657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "415 S 28TH AVE",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394017246",
"telephone_number": "601-268-5800",
"fax_number": "601-579-5240"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 S 28TH AVE",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394017246",
"telephone_number": "601-268-5800",
"fax_number": "601-261-3530"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITEHEAD",
"first_name": "GINA",
"middle_name": "ROCHELLE",
"credential": "DNP, FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-10",
"last_updated": "2020-07-30",
"certification_date": "2020-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MS",
"license": "903173",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "903173",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "08971821",
"state": "MS"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "gwhitehead84219@directpatientrecord.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "415 S 28th Ave",
"city": "Hattiesburg",
"state": "MS",
"country_code": "US",
"postal_code": "394017246",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.