Active NPI
Desiree L Whitacre, RN
- School Registered Nurse
- London, OH
National Provider Identifier
1396356135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Registered Nurse
- License
- RN.277049
- Practice address
- 270 Keny Blvd
London, OH 43140-9040 - Phone
- (740) 852-5701
- Fax
- (740) 845-1279
- NPI assigned
- Aug 14, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | RN.277049 | OH | Primary |
Addresses
Primary practice location
270 Keny Blvd
London, OH 43140-9040
Mailing address
2055 Old Columbus Rd
London, OH 43140-8608
Phone (161) 498-9306
Other practice location 1
336 Elm St
London, OH 43140-9220
Phone (740) 852-5705 ext. 4055
Other practice location 2
380 Elm St
London, OH 43140-9220
Phone (740) 845-3272
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN.277049 | OH | MD | School Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| London City Schools | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Early Intervention Provider Agency
- London, OH
- NPI 1891119509
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597363200000",
"number": "1396356135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2055 OLD COLUMBUS RD",
"city": "LONDON",
"state": "OH",
"postal_code": "431408608",
"telephone_number": "161-498-9306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "270 KENY BLVD",
"city": "LONDON",
"state": "OH",
"postal_code": "431409040",
"telephone_number": "740-852-5701",
"fax_number": "740-845-1279"
}
],
"practiceLocations": [
{
"address_1": "336 Elm St",
"address_purpose": "LOCATION",
"city": "London",
"state": "OH",
"postal_code": "431409220",
"country_code": "US",
"telephone_number": "740-852-5705 x4055",
"fax_number": "740-845-3284",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "380 Elm St",
"address_purpose": "LOCATION",
"city": "London",
"state": "OH",
"postal_code": "431409220",
"country_code": "US",
"telephone_number": "740-845-3272",
"fax_number": "740-845-3283",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WHITACRE",
"first_name": "DESIREE",
"middle_name": "L",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-14",
"last_updated": "2020-08-14",
"certification_date": "2020-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "163WS0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, School",
"state": "OH",
"license": "RN.277049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in London, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.