Individual provider Active NPI

Erica Anne White

  • Family Nurse Practitioner
  • Jefferson City, MO
National Provider Identifier
1053081752
Registry record updated Sep 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F07210129 Issued in MO
Practice address
1125 Madison St
Jefferson City, MO 65101-5227
Phone
(573) 632-5337
NPI assigned
Sep 15, 2021
Last updated
Sep 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F07210129 MO Primary

Addresses

Primary practice location

1125 Madison St
Jefferson City, MO 65101-5227

Mailing address

515 Pheasant Run Rd
Jefferson City, MO 65109-4137
Phone (573) 821-4119

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211118000158 MO Practitioner - Nurse Practitioner 3173912821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

1511 Christy Dr
Jefferson City, MO 65101-2854
Phone (573) 632-2777

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F07210129MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Ctr of Central Missouri Current Accepting new patients
Community Health Ctr of Central Missouri CurrentSince Nov 1, 2021 Accepting new patients

Locations

1511 Christy Dr
Jefferson Cty, MO 65101
Phone (573) 606-6924

Interoperability endpoints

  • Direct secure messaging: erica.white.p1@direct.chccmo.nextgenshare.com

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1631664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631664000000",
    "number": "1053081752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 PHEASANT RUN RD",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651094137",
            "telephone_number": "573-821-4119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 MADISON ST",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651015227",
            "telephone_number": "573-632-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "ERICA",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-15",
        "last_updated": "2021-09-15",
        "certification_date": "2021-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "F07210129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson City, MO

Sources for this page

Verify at the official NPI Registry.