Individual provider Active NPI

Elizabeth Katherine White

  • Occupational Therapist
  • Roanoke Rapids, NC
National Provider Identifier
1336901636
Registry record updated Jan 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
14673 Issued in NC
Practice address
250 Smith Church Rd
Roanoke Rapids, NC 27870-4914
Phone
(252) 535-8011
NPI assigned
Jan 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 14673 NC Primary

Addresses

Primary practice location

250 Smith Church Rd
Roanoke Rapids, NC 27870-4914

Mailing address

715 N Church St
Jackson, NC 27845-9773
Phone (252) 813-6971

Other practice location 1

200 Hampton Woods Complex Rd
Jackson, NC 27845-9503
Phone (252) 534-0131

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

LicenseStateTypeSpecialty
14673NCMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705968000000",
    "number": "1336901636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 N CHURCH ST",
            "city": "JACKSON",
            "state": "NC",
            "postal_code": "278459773",
            "telephone_number": "252-813-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 SMITH CHURCH RD",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278704914",
            "telephone_number": "252-535-8011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hampton Woods Complex Rd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "NC",
            "postal_code": "278459503",
            "country_code": "US",
            "telephone_number": "252-534-0131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "ELIZABETH",
        "middle_name": "KATHERINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-23",
        "last_updated": "2024-01-23",
        "certification_date": "2024-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "14673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke Rapids, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.