Active NPI
Gary William Whitham, PHARMACIST
- Pharmacist
- Syracuse, NY
National Provider Identifier
1285818260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 030026
- Practice address
- 1820 Teall Ave
Syracuse, NY 13206 - Phone
- (315) 437-1531
- NPI assigned
- Dec 26, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | 030026 | NY | Primary |
Addresses
Primary practice location
1820 Teall Ave
Syracuse, NY 13206
Mailing address
1820 Teall Ave.
Syracuse, NY 13206
Phone (315) 437-1531
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00482779 | Medicaid | NY |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 030026 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198627200000",
"number": "1285818260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1820 TEALL AVE.",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "13206",
"telephone_number": "315-437-1531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1820 TEALL AVE",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "13206",
"telephone_number": "315-437-1531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITHAM",
"first_name": "GARY",
"middle_name": "WILLIAM",
"name_prefix": "Mr.",
"credential": "PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-12-26",
"last_updated": "2007-12-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "030026",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00482779",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 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.