Mary A White, CPNP-PC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

NN78638 Issued in NJ

Practice address

101 2ND St
Lakewood, NJ 08701-3324

Phone

(732) 363-6655

NPI assigned

Jan 31, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mary.white.1@11915.direct.athenahealth.com

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.

• Ocean Health Initiatives Inc

  • Federally Qualified Health Center (FQHC)
  • Lakewood, NJ
  • NPI 1043306574
  Medicare reassignment NPD
• Ocean Health Initiatives, Inc

  • Federally Qualified Health Center (FQHC)
  • Toms River, NJ
  • NPI 1417938044
  NPD
• Ocean Health Initiatives, Inc.

  • Federally Qualified Health Center (FQHC)
  • Brick, NJ
  • NPI 1679096796
  NPD
• Ocean Health Initiatives

  • Federally Qualified Health Center (FQHC)
  • Lakewood, NJ
  • NPI 1710980917
  NPD (past)

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

{
    "created_epoch": "1675123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1538865779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "991 BEACH HAVEN WEST BLVD",
            "city": "MANAHAWKIN",
            "state": "NJ",
            "postal_code": "080503812",
            "telephone_number": "732-266-3587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 2ND ST",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087013324",
            "telephone_number": "732-363-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "MARY",
        "middle_name": "A",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-31",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "NN78638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Anne Whalen, ATC
• Gary M Wheeler, D.M.D.
• White Dove ABA
• White Glove Health Services
• Erin Elizabeth White, LCSW
• Jennifer L Whitman, PA-C
• Whole and Healthy Dietary Counseling
• Dina Wieder, OTR/L
• Yehoshua Wiederkehr, PA-C
• Sarah Deena Wiedermann, LCSW

• Pediatric Nurse Practitioner in Lakewood, NJ
• Providers in Lakewood, NJ by specialty
• Pediatric Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.