Active NPI
Jessica L Whitby, LAT, ATC
- Athletic Trainer
- Raleigh, NC
National Provider Identifier
1255760104
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2314
- Practice address
- 11200 Governor Manly Way
Suite 309
Raleigh, NC 27614-8599 - Phone
- (919) 562-9410
- NPI assigned
- Nov 1, 2013
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2314 | NC | Primary |
Addresses
Primary practice location
11200 Governor Manly Way
Suite 309
Raleigh, NC 27614-8599
Mailing address
11200 Governor Manly Way
Suite 309
Raleigh, NC 27614-8599
Phone (919) 562-9410
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383264000000",
"number": "1255760104",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11200 GOVERNOR MANLY WAY",
"address_2": "SUITE 309",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276148599",
"telephone_number": "919-562-9410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11200 GOVERNOR MANLY WAY",
"address_2": "SUITE 309",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276148599",
"telephone_number": "919-562-9410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITBY",
"first_name": "JESSICA",
"middle_name": "L",
"credential": "LAT, ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-01",
"last_updated": "2013-11-01",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "NC",
"license": "2314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.