Individual provider Active NPI

Janice L Whitley, CFO

  • Prosthetic/Orthotic Supplier
  • Albemarle, NC
National Provider Identifier
1497059828
Registry record updated Dec 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
7795213 Issued in NC
Practice address
107 Moss Springs Rd
Albemarle, NC 28001-5140
Phone
(704) 983-6770
Fax
(704) 983-6160
NPI assigned
Dec 28, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 7795213 NC Primary

Addresses

Primary practice location

107 Moss Springs Rd
Albemarle, NC 28001-5140

Mailing address

PO Box 192
107 Moss Springs Rd
Albemarle, NC 28002-0192
Phone (704) 983-6770

Other identifiers 2

IdentifierTypeStateIssuer
7795213MedicaidNC
5132230001OtherNCNPI FOR MEDICARE 1639135536

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

State licenses

LicenseStateTypeSpecialty
7795213NCMDProsthetic/Orthotic Supplier

Practice roles

OrganizationSpecialtyStatusNew patients
Janice L. Whitley Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1293494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293494400000",
    "number": "1497059828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 192",
            "address_2": "107 MOSS SPRINGS RD",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280020192",
            "telephone_number": "704-983-6770",
            "fax_number": "704-983-6160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 MOSS SPRINGS RD",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280015140",
            "telephone_number": "704-983-6770",
            "fax_number": "704-983-6160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITLEY",
        "first_name": "JANICE",
        "middle_name": "L",
        "credential": "CFO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-28",
        "last_updated": "2010-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "NC",
            "license": "7795213",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7795213",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI FOR MEDICARE    1639135536",
            "identifier": "5132230001",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albemarle, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 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.

Verify at the official NPI Registry.