Active NPI
Stephen Allen White II
- Physical Therapy Assistant
- Lafayette, IN
National Provider Identifier
1013750256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 06005654A
- Practice address
- 2201 Cason St
Lafayette, IN 47904-2697 - Phone
- (765) 447-4102
- NPI assigned
- Jun 17, 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 06005654A | IN | Primary |
Addresses
Primary practice location
2201 Cason St
Lafayette, IN 47904-2697
Mailing address
710 Mustang Way
Lafayette, IN 47905-3419
Phone (724) 988-9197
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06005654A | IN | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1718582400000",
"number": "1013750256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "710 MUSTANG WAY",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479053419",
"telephone_number": "724-988-9197"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2201 CASON ST",
"city": "LAFAYETTE",
"state": "IN",
"postal_code": "479042697",
"telephone_number": "765-447-4102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "STEPHEN",
"middle_name": "ALLEN",
"name_prefix": "Mr.",
"name_suffix": "II",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-17",
"last_updated": "2024-06-17",
"certification_date": "2024-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "IN",
"license": "06005654A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.