Demeitrius M Whitehurst, B.A., CSAC, QMHP-A-C

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

0710102215 Issued in VA

Practice address

12388 Warwick Blvd Ste 302, Newport News, VA 23602
Ste 302
Norfolk, VA 23606-2360

Phone

(757) 679-6058

NPI assigned

Sep 27, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

State licenses

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.

• DPC Jewett LLC

  dba Dominion Patient Care Services

  • Health Maintenance Organization
  • Newport News, VA
  • NPI 1366975633
  NPD (past)
• Sentara Medical Group

  • Family Medicine Physician
  • Norfolk, VA
  • NPI 1265485270
  NPD (past)

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

{
    "created_epoch": "1538006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538006400000",
    "number": "1407331135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12388 WARWICK BLVD STE 302",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236063858",
            "telephone_number": "757-679-6058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12388 WARWICK BLVD STE 302, NEWPORT NEWS, VA 23602",
            "address_2": "STE 302",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "236062360",
            "telephone_number": "757-679-6058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITEHURST",
        "first_name": "DEMEITRIUS",
        "middle_name": "M",
        "credential": "B.A., CSAC, QMHP-A-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-27",
        "last_updated": "2018-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0710102215",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "000000000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas J White, M.D.
• Sharonda White, CNA
• Tareka L White, LCSW
• White's Medical Transport, LLC
• Shawnnell Trammel Whitehead, LPC
• Mary Candace Whitehurst, MD
• Twanna Whitehurst
• Daniel Robert Whitenack, D.C.
• John Whitenton
• Mary Catherine Whiteside

• Addiction (Substance Use Disorder) Counselor in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Addiction (Substance Use Disorder) Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2018; 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.