Active NPI
Phillip White
- Clinical Social Worker
- Wake Forest, NC
National Provider Identifier
1598147704
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- P009730
- Practice address
- 1213 Opeushaw CT
Wake Forest, NC 27587-7938 - Phone
- (252) 767-1011
- NPI assigned
- Jun 24, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | P009730 | NC | Primary |
Addresses
Primary practice location
1213 Opeushaw CT
Wake Forest, NC 27587-7938
Mailing address
1213 Opeushaw CT
Wake Forest, NC 27587
Phone (252) 767-1011
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 |
|---|---|---|---|
| P009730 | NC | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435104000000",
"number": "1598147704",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1213 OPEUSHAW CT",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "27587",
"telephone_number": "252-767-1011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1213 OPEUSHAW CT",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275877938",
"telephone_number": "252-767-1011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "PHILLIP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-24",
"last_updated": "2015-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NC",
"license": "P009730",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wake Forest, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.