Individual provider Active NPI

Jamie Pawlina White Bastable, RN

  • Primary Care Nurse Practitioner
  • Greensboro, NC
National Provider Identifier
1528823929
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
5020125 Issued in NC
Practice address
2703 Henry St
Greensboro, NC 27405-3669
Phone
(336) 621-8911
Fax
(336) 621-6322
NPI assigned
Feb 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 5020125 NC Primary

Addresses

Primary practice location

2703 Henry St
Greensboro, NC 27405-3669

Mailing address

124 E Gate City Blvd
Greensboro, NC 27406-1457

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240918001491 NC Practitioner - Nurse Practitioner 5395286322 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
5020125NCMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Guilford Medical Associates PA CurrentSince Jun 5, 2024 Accepting new patients
Choice Consulting Services, PLLC PastSince Jun 2, 2024 Accepting new patients

Locations

2703 Henry St
Greensboro, NC 27405
Phone (336) 621-8911

Organizations & group practices 2

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": "1707955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1528823929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 E GATE CITY BLVD",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274061457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2703 HENRY ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274053669",
            "telephone_number": "336-621-8911",
            "fax_number": "336-621-6322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTABLE",
        "first_name": "JAMIE",
        "middle_name": "PAWLINA WHITE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-15",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "NC",
            "license": "5020125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.