Active NPI
Tyler Lee White, FNP-C
- Family Nurse Practitioner
- Bedford, IN
National Provider Identifier
1003674946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 71015039A
- Practice address
- 629 Lincoln Ave
Bedford, IN 47421-2142 - Phone
- (812) 675-4470
- Fax
- (812) 675-4469
- NPI assigned
- Mar 6, 2024
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 71015039A | IN | Primary |
Addresses
Primary practice location
629 Lincoln Ave
Bedford, IN 47421-2142
Mailing address
6402 Asbell Rd
Shoals, IN 47581-7839
Phone (812) 296-8238
Other practice location 1
3 E Main St
Washington, IN 47501-2907
Phone (812) 486-6639
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240517003155 | IN | Practitioner - Nurse Practitioner | 1658712872 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Southern Indiana Community Health Care Inc
Practice addresses (Care Compare)
420 W Longest St
Paoli, IN 47454-8821
Phone (812) 723-3944
Hospital & facility affiliations
- Indiana University Health Bedford Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71015039A | IN | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Indiana Community Health Care, Inc | Current | Accepting new patients | |
| Southern Indiana Community Health Care, Inc | Current | Accepting new patients | |
| Wrightchoice Healthcare, LLC | Family | Current | Accepting new patients |
| Southern Indiana Community Health Care, Inc | Past | Accepting new patients | |
| Southern Indiana Community Health Care, Inc | Past | Accepting new patients | |
| Southern Indiana Community Health Care, Inc | Past | Accepting new patients |
Locations
629 Lincoln Ave
Bedford, IN 47421
Phone (812) 277-1702
420 W Longest St
Paoli, IN 47454
Phone (812) 723-3944
3 E Main St
Washington, IN 47501
Phone (812) 486-6639
Interoperability endpoints
- tylerwhite@sichc.allscriptsdirect.net
Organizations & group practices 10
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.
-
- Federally Qualified Health Center (FQHC)
- Bedford, IN
- NPI 1407566631
-
- Federally Qualified Health Center (FQHC)
- Orleans, IN
- NPI 1356911390
-
- Federally Qualified Health Center (FQHC)
- English, IN
- NPI 1629585591
-
- Federally Qualified Health Center (FQHC)
- Marengo, IN
- NPI 1902313992
-
- Federally Qualified Health Center (FQHC)
- Paoli, IN
- NPI 1386151371
-
- Federally Qualified Health Center (FQHC)
- Mitchell, IN
- NPI 1427768647
-
- Federally Qualified Health Center (FQHC)
- Salem, IN
- NPI 1639772353
-
- Federally Qualified Health Center (FQHC)
- West Baden Springs, IN
- NPI 1841706868
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709683200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1729036800000",
"number": "1003674946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6402 ASBELL RD",
"city": "SHOALS",
"state": "IN",
"postal_code": "475817839",
"telephone_number": "812-296-8238"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "629 LINCOLN AVE",
"city": "BEDFORD",
"state": "IN",
"postal_code": "474212142",
"telephone_number": "812-675-4470",
"fax_number": "812-675-4469"
}
],
"practiceLocations": [
{
"address_1": "3 E Main St",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "IN",
"postal_code": "475012907",
"country_code": "US",
"telephone_number": "812-486-6639",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WHITE",
"first_name": "TYLER",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-06",
"last_updated": "2024-10-16",
"certification_date": "2024-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IN",
"license": "71015039A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bedford, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.