Jessica Suzanne Whitaker, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

4183 Issued in SC

Practice address

303 Calming Way
Tega Cay, SC 29708-8241

Phone

(704) 771-9094

NPI assigned

Oct 5, 2015

Sex

Female

Sole proprietor

Yes

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

Enrolled in SC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Collective Therapy CorpGroup PAC ID 0143651802, 75 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Collective Therapy Corp.

  • Speech-Language Pathologist
  • Charlotte, NC
  • NPI 1396380911

  Physical Therapist, SC

  Medicare reassignment Care Compare group NPD
• Charlotte Neuroscience Foundation

  • Neurology Physician
  • Charlotte, NC
  • NPI 1508394750
  NPD (past)

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444003200000",
    "number": "1427428366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 CALMING WAY",
            "city": "TEGA CAY",
            "state": "SC",
            "postal_code": "297088241",
            "telephone_number": "704-771-9094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 CALMING WAY",
            "city": "TEGA CAY",
            "state": "SC",
            "postal_code": "297088241",
            "telephone_number": "704-771-9094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITAKER",
        "first_name": "JESSICA",
        "middle_name": "SUZANNE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-05",
        "last_updated": "2015-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "4183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Heather Lynn Ward, M.A., CCC-SLP
• We
• Wellmore of Tega Cay, LLC
• Wendy Wingard-Gay, MS CCC/SLP
• Brett Alexandra Wnuk, MSN, APRN, PMHNP-BC

• Physical Therapist in Tega Cay, SC
• Providers in Tega Cay, SC by specialty
• Physical Therapist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.