Active NPI
Jessica J Whitley, MD
- Internal Medicine Physician
- Willoughby, OH
National Provider Identifier
1477533180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 35086616
- Practice address
- 36000 Euclid Ave
Willoughby, OH 44094-4625 - Phone
- (440) 953-9600
- NPI assigned
- Jan 19, 2006
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 35086616 | OH | Primary |
Addresses
Primary practice location
36000 Euclid Ave
Willoughby, OH 44094-4625
Mailing address
PO Box 200466
Pittsburgh, PA 15251-0466
Phone (440) 542-5023
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2596481 | Medicaid | OH |
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
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137628800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271980800000",
"number": "1477533180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 200466",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152510466",
"telephone_number": "440-542-5023",
"fax_number": "440-542-5029"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36000 EUCLID AVE",
"city": "WILLOUGHBY",
"state": "OH",
"postal_code": "440944625",
"telephone_number": "440-953-9600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITLEY",
"first_name": "JESSICA",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-19",
"last_updated": "2010-04-23",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "OH",
"license": "35086616",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2596481",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Willoughby, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.