Individual provider Active NPI

Janet Marie Whidby, PHD

  • Clinical Psychologist
  • Charlotte, NC
National Provider Identifier
1699880062
Registry record updated Sep 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2024 Issued in NC
Practice address
3541 Randolph Rd
Suite 206
Charlotte, NC 28211-1082
Phone
(704) 381-8376
Fax
(704) 381-8832
NPI assigned
Aug 19, 2006
Last updated
Sep 9, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2024 NC Primary

Addresses

Primary practice location

3541 Randolph Rd
Suite 206
Charlotte, NC 28211-1082

Mailing address

3541 Randolph Rd
Suite 206
Charlotte, NC 28211-1082
Phone (704) 381-8365

Other identifiers 1

IdentifierTypeStateIssuer
6000358MedicaidNC

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2024NCMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378684800000",
    "number": "1699880062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3541 RANDOLPH RD",
            "address_2": "SUITE 206",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111082",
            "telephone_number": "704-381-8365"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3541 RANDOLPH RD",
            "address_2": "SUITE 206",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111082",
            "telephone_number": "704-381-8376",
            "fax_number": "704-381-8832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHIDBY",
        "first_name": "JANET",
        "middle_name": "MARIE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2013-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000358",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2013; 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.