Active NPI
Judith Gail Whitman, P.A.-C
- Physician Assistant
- Fleming Island, FL
National Provider Identifier
1467504720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA 3496
- Practice address
- 2349 Village Square Park Way
Suite 107
Fleming Island, FL 32003 - Phone
- (904) 389-1010
- Fax
- (904) 389-1082
- NPI assigned
- Jan 17, 2007
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA 3496 | FL | Primary |
Addresses
Primary practice location
2349 Village Square Park Way
Suite 107
Fleming Island, FL 32003
Mailing address
6195 Lake Gray Blvd
Suite 4
Jacksonville, FL 32244-5891
Phone (904) 389-1010
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA 3496 | FL | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Spine Georgia | Past | Accepting new patients | |
| Power Spine & Pain | Past | Accepting new patients | |
| First Coast Primary Care Inc | Past | Accepting new patients | |
| St Vincents Ambulatory Care Inc | Past | Accepting new patients |
Interoperability endpoints
- judith.whitman.p2@direct.painreliefcenters.nextgenshare.com
- https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
- judith.whitman.p1@direct.riversidepain.nextgenshare.com
Organizations & group practices 4
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.
-
- Family Medicine Physician
- Jacksonville, FL
- NPI 1528197993
-
- Interventional Pain Medicine Physician
- Saint Augustine, FL
- NPI 1558133694
-
- Neurological Surgery Physician
- Jacksonville, FL
- NPI 1417987124
-
- Interventional Pain Medicine Physician
- Richmond Hill, GA
- NPI 1942670658
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489017600000",
"number": "1467504720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6195 LAKE GRAY BLVD",
"address_2": "SUITE 4",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322445891",
"telephone_number": "904-389-1010",
"fax_number": "904-389-1082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2349 VILLAGE SQUARE PARK WAY",
"address_2": "SUITE 107",
"city": "FLEMING ISLAND",
"state": "FL",
"postal_code": "32003",
"telephone_number": "904-389-1010",
"fax_number": "904-389-1082"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITMAN",
"first_name": "JUDITH",
"middle_name": "GAIL",
"credential": "P.A.-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-17",
"last_updated": "2017-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA 3496",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fleming Island, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.