Mikkala Elizabeth Whited

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

Practice address

24 Cherry St
Johnson City, NY 13790-2615

Phone

(607) 723-8313

NPI assigned

Oct 7, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Child Development Council

  • Early Intervention Provider Agency
  • Johnson City, NY
  • NPI 1972748853
  NPD (past)

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

{
    "created_epoch": "1665100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1336864735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 CHERRY ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902615",
            "telephone_number": "607-238-6906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 CHERRY ST",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "137902615",
            "telephone_number": "607-723-8313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITED",
        "first_name": "MIKKALA",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-07",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Rose Welte
• Donna T West, NP
• Pauline Westcott, OTR/L
• Stephanie Ann Westgate, M.A.-CCC/SLP
• Jennifer Whelan
• Isuru Udayanga Wijesinghe, D.O.
• Olayinka O Wilhelm, MD
• Alexander Williams
• Kord Williams, F.N.P
• Lisa Williams, OTR-L

• Physical Therapy Assistant in Johnson City, NY
• Providers in Johnson City, NY by specialty
• Physical Therapy Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.