Active NPI
Janice L Whitley, CFO
- Prosthetic/Orthotic Supplier
- Albemarle, NC
National Provider Identifier
1497059828
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetic/Orthotic Supplier
- License
- 7795213
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7795213 | Medicaid | NC | |
| 5132230001 | Other | NC | NPI 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
| License | State | Type | Specialty |
|---|---|---|---|
| 7795213 | NC | MD | Prosthetic/Orthotic Supplier |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Durable Medical Equipment & Medical Supplies
- Albemarle, NC
- NPI 1639135536
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.