Active NPI
Brandon Harold Whitehouse, PRSS
- Peer Specialist
- Princeton, WV
National Provider Identifier
1316680549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- 18-918
- Practice address
- 1345 Mercer St
Princeton, WV 24740-3033 - Phone
- (304) 818-2222
- NPI assigned
- Apr 15, 2022
- 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 |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 18-918 | WV | Primary |
Addresses
Primary practice location
1345 Mercer St
Princeton, WV 24740-3033
Mailing address
200 12TH Street Ext
Princeton, WV 24740-2329
Phone (304) 818-2222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 764876480 | Medicaid | WV |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | brandonwhitehouse@shcmhc.com | Direct | |
| Other URL | https://shcmhc.com/ | Direct |
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 |
|---|---|---|---|
| 18-918 | WV | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649980800000",
"number": "1316680549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 12TH STREET EXT",
"city": "PRINCETON",
"state": "WV",
"postal_code": "247402329",
"telephone_number": "304-818-2222"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1345 MERCER ST",
"city": "PRINCETON",
"state": "WV",
"postal_code": "247403033",
"telephone_number": "304-818-2222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITEHOUSE",
"first_name": "BRANDON",
"middle_name": "HAROLD",
"credential": "PRSS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-04-15",
"last_updated": "2022-04-15",
"certification_date": "2022-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "WV",
"license": "18-918",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "764876480",
"state": "WV"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "brandonwhitehouse@shcmhc.com",
"affiliation": "N",
"endpointDescription": "email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "200 12th Street Ext",
"city": "Princeton",
"state": "WV",
"country_code": "US",
"postal_code": "247402329",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "https://shcmhc.com/",
"affiliation": "N",
"endpointDescription": "Website",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "1345 Mercer St",
"city": "Princeton",
"state": "WV",
"country_code": "US",
"postal_code": "247403033",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Princeton, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.