Jacquelyn Lee White, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

5850 Coral Ridge Dr
Suite 106
Coral Springs, FL 33076-3378

Phone

(954) 714-8200

Fax

(954) 840-2626

NPI assigned

Jan 31, 2013

Last updated

Jan 31, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1359590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1801135561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5850 CORAL RIDGE DR",
            "address_2": "SUITE 106",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330763378",
            "telephone_number": "954-714-8200",
            "fax_number": "954-840-2626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5850 CORAL RIDGE DR",
            "address_2": "SUITE 106",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330763378",
            "telephone_number": "954-714-8200",
            "fax_number": "954-840-2626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JACQUELYN",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-31",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tim Scott Weyant, P.T.
• Shea Lynn Whinnery
• Jessica White Videa, DO
• Alyssa White
• Courtney Cristine White
• Teresa Lynn White, LMT, LPN
• Chennelle Ann-Marie Whitely, APRN
• Jacqueline Ashley-Nicole Whitney
• Whole Mind and Body Wellness LLC
• Deanna J Whoriskey, P.T.

• Physician Assistant in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.