Jean King White, MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

MD.016890 Issued in LA

Practice address

1717 Oak Park Blvd FL 2
Lake Charles, LA 70601-8990

Phone

(337) 494-3278

Fax

(337) 494-3240

NPI assigned

Sep 20, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Southwest Louisiana Hospital Association Inc

  • Interventional Cardiology Physician
  • Lake Charles, LA
  • NPI 1902326572
  Medicare reassignment NPD
• West Louisiana Health Services Inc

  • Obstetrics & Gynecology Physician
  • Deridder, LA
  • NPI 1164985495
  Medicare reassignment NPD
• Cardiovascular Specialists of Southwest Louisiana, LLC

  • Cardiovascular Disease Physician
  • Lake Charles, LA
  • NPI 1083711006
  NPD
• Southwest Louisiana Hospital Association Inc

  • Gastroenterology Physician
  • Lake Charles, LA
  • NPI 1285351411
  NPD
• Christus Health Southwestern Louisiana

  • General Acute Care Hospital
  • Lake Charles, LA
  • NPI 1629076468
  NPD (past)
• Mulhearn Medical, LLC

  • Interventional Cardiology Physician
  • Lake Charles, LA
  • NPI 1184916371
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1003913070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122152 DEPT 2152",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753120001",
            "telephone_number": "337-494-2921",
            "fax_number": "337-494-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 OAK PARK BLVD FL 2",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018990",
            "telephone_number": "337-494-3278",
            "fax_number": "337-494-3240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "122 W 4th St",
            "address_purpose": "LOCATION",
            "city": "Dequincy",
            "state": "LA",
            "postal_code": "706333508",
            "country_code": "US",
            "telephone_number": "337-494-3278",
            "fax_number": "337-494-3240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "913 E Kent Dr",
            "address_purpose": "LOCATION",
            "city": "Sulphur",
            "state": "LA",
            "postal_code": "706635007",
            "country_code": "US",
            "telephone_number": "337-527-3610",
            "fax_number": "337-527-6063",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1322 Elton Rd Ste P",
            "address_purpose": "LOCATION",
            "city": "Jennings",
            "state": "LA",
            "postal_code": "705464100",
            "country_code": "US",
            "telephone_number": "337-494-3278",
            "fax_number": "337-494-3240",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "109 W 4th St",
            "address_purpose": "LOCATION",
            "city": "Deridder",
            "state": "LA",
            "postal_code": "706344849",
            "country_code": "US",
            "telephone_number": "337-494-3278",
            "fax_number": "337-494-3240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JEAN",
        "middle_name": "KING",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "LA",
            "license": "MD.016890",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "LA",
            "license": "MD.016890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE MEDICAL LICENSE",
            "identifier": "MD.016890",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1377970",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christian Charles White
• Crystal Nicole White, FNP
• Dedric Dyron White
• Eddie White
• James D White
• Katrina Hope White
• Kia White
• Laura Marie White, OTR
• Melanie Bousegard White, FNP
• Rachel White

• Interventional Cardiology Physician in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Interventional Cardiology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.