Individual provider Active NPI

Barbara Gloria Whitten, NP

  • Nurse Practitioner
  • Roswell, NM
National Provider Identifier
1902860075
Registry record updated Feb 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
CNP00094 Issued in NM
Practice address
402 W Country Club Rd
Roswell, NM 88201
Phone
(575) 637-7000
Fax
(575) 637-7019
NPI assigned
Apr 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R12264 NM
Nurse Practitioner 363L00000X CNP00094 NM Primary

Addresses

Primary practice location

402 W Country Club Rd
Roswell, NM 88201

Mailing address

3420 22ND Place
Lubbock, TX 79410
Phone (806) 725-7800

Other identifiers 1

IdentifierTypeStateIssuer
000H3421MedicaidNM

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
CNP00094NMMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328054400000",
    "number": "1902860075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 22ND PLACE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79410",
            "telephone_number": "806-725-7800",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W COUNTRY CLUB RD",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "88201",
            "telephone_number": "575-637-7000",
            "fax_number": "575-637-7019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTEN",
        "first_name": "BARBARA",
        "middle_name": "GLORIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2012-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "R12264",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "CNP00094",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000H3421",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2012; 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.