Individual provider Active NPI

Keyona Nichole White, CTRS

  • Recreation Therapist
  • Charles Town, WV
National Provider Identifier
1477071256
Registry record updated Aug 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Recreation TherapistTaxonomy code 225800000X
Practice address
16 Bushrod CT
Charles Town, WV 25414-4430
Phone
(703) 554-9047
NPI assigned
Aug 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Recreation Therapist 225800000X Primary

Addresses

Primary practice location

16 Bushrod CT
Charles Town, WV 25414-4430

Mailing address

16 Bushrod CT
Charles Town, WV 25414-4430

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

NPI Registry JSON

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

{
    "created_epoch": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504137600000",
    "number": "1477071256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BUSHROD CT",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254144430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 BUSHROD CT",
            "city": "CHARLES TOWN",
            "state": "WV",
            "postal_code": "254144430",
            "telephone_number": "703-554-9047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KEYONA",
        "middle_name": "NICHOLE",
        "credential": "CTRS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-31",
        "last_updated": "2017-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charles Town, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.

Verify at the official NPI Registry.