Individual provider Active NPI

Jeffery Alan White, D.O.

  • Orthopaedic Surgery Physician
  • Fort Polk, LA
National Provider Identifier
1013113356
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
2009-00317 Issued in NC
Practice address
1585 3Rd St
Fort Polk, LA 71459-5102
Phone
(337) 531-3896
NPI assigned
Jun 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2009-00317 NC Primary

Addresses

Primary practice location

1585 3Rd St
Fort Polk, LA 71459-5102

Mailing address

1585 3Rd St
Fort Polk, LA 71459-5102
Phone (337) 531-3896

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, OR2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240830002164 TX Practitioner - Orthopedic Surgery 5597204701 Reassigns benefits to 1 organization
I20250103000428 OR Practitioner - Orthopedic Surgery 5597204701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Philadelphia College of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Corner of Route N12 and N7
Fdihb Inc.
Fort Defiance, AZ 86504-0649
Phone (928) 729-8082

PO Box
Suite 649
Fort Defiance, AZ 86504-0649

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Bay Area Hospital District CurrentSince Dec 20, 2024 Accepting new patients
Bay Area Hospital District CurrentSince Dec 20, 2024 Accepting new patients
The Fort Defiance Indian Hospital Board, Incorporation CurrentSince Aug 19, 2024 Accepting new patients

Locations

Dept LA 25339
Pasadena, CA 91185

2650 N 17th St
Coos Bay, OR 97420
Phone (541) 267-5411

1775 Thompson Rd
Coos Bay, OR 97420
Phone (541) 269-8090

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650844800000",
    "number": "1013113356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1585 3RD ST",
            "city": "FORT POLK",
            "state": "LA",
            "postal_code": "714595102",
            "telephone_number": "337-531-3896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1585 3RD ST",
            "city": "FORT POLK",
            "state": "LA",
            "postal_code": "714595102",
            "telephone_number": "337-531-3896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JEFFERY",
        "middle_name": "ALAN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "2009-00317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Polk, LA

Sources for this page

Verify at the official NPI Registry.