Whitaker Glen, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

NH0007 Issued in NC

Legal business name

WHITAKER GLEN, INC.

Practice address

513 E Whitaker Mill Road
Raleigh, NC 27608-2699

Phone

(919) 828-2348

Fax

(919) 828-7554

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Neil L. Pruitt Jr.

Title

Chairman and Ceo

Phone

(770) 279-6200

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• The Oaks at Whitaker Glen - Mayview Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416268800000",
    "number": "1366529406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1626 JEURGENS CT",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300932219",
            "telephone_number": "770-279-6200",
            "fax_number": "770-931-5278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 E WHITAKER MILL ROAD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276082699",
            "telephone_number": "919-828-2348",
            "fax_number": "919-828-7554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITAKER GLEN, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2014-11-18",
        "status": "A",
        "authorized_official_last_name": "PRUITT",
        "authorized_official_first_name": "NEIL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "CHAIRMAN AND CEO",
        "authorized_official_telephone_number": "770-279-6200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "NH0007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3415009",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSNC",
            "identifier": "00876",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3416061",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Oaks at Whitaker Glen - Mayview",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan Michelle Whichard, PH.D.
• Alexandra Theresa Whicker, MA, LCMHC-A, ATR-BC
• Lamar Whidbee
• Hannah Whisler
• Whispers of Serenity Counseling and Consulting PLLC
• Ann E Whitaker, PA
• April Whitaker
• Deja Monet Whitaker, M.S. CCC-SLP
• Felicia Whitaker
• Stephanie Whitaker

• Skilled Nursing Facility in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Skilled Nursing Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.