Individual provider Active NPI

Andrew White, MD

  • Emergency Medicine Physician
  • Rogers, AR
National Provider Identifier
1063892529
Registry record updated Jun 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
E-11984 Issued in AR
Practice address
2710 S Rife Medical LN
Rogers, AR 72758
Phone
(479) 338-8000
NPI assigned
May 31, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 31420 OK
Emergency Medicine Physician 207P00000X E-11984 AR Primary

Addresses

Primary practice location

2710 S Rife Medical LN
Rogers, AR 72758

Mailing address

1201 NE Bluff Spring Ave
Bentonville, AR 72712-8964
Phone (501) 701-8830

Other practice location 1

900 NE 10th St
FMC 2102
Oklahoma City, OK 73104-5420
Phone (405) 271-2230

Other practice location 2

900 NE 10th St
FMC 2102
Oklahoma City, OK 73104-5420
Phone (405) 271-2230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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

Enrollment IDStateProvider typePAC IDDetails
I20190828000354 AR Practitioner - Emergency MedicinePractitioner - Family Practice 4385950468 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Karas Family Walk in Clinic CurrentSince Dec 28, 2019 Accepting new patients
Southeastern Emergency Physicians LLC Emergency Medicine CurrentSince Aug 1, 2019 Accepting new patients

Locations

767 W North St
Fayetteville, AR 72701
Phone (479) 521-3600

1041 N Garland Ave
Fayetteville, AR 72701
Phone (479) 966-5088

4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100

2710 S Rife Medical Ln
Rogers, AR 72758
Phone (479) 338-8000

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.

NPI Registry JSON

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

{
    "created_epoch": "1433030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1063892529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 NE BLUFF SPRING AVE",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727128964",
            "telephone_number": "501-701-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2710 S RIFE MEDICAL LN",
            "city": "ROGERS",
            "state": "AR",
            "postal_code": "72758",
            "telephone_number": "479-338-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 NE 10th St",
            "address_2": "FMC 2102",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731045420",
            "country_code": "US",
            "telephone_number": "405-271-2230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 NE 10th St",
            "address_2": "FMC 2102",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731045420",
            "country_code": "US",
            "telephone_number": "405-271-2230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-31",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "31420",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AR",
            "license": "E-11984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rogers, AR

Sources for this page

Verify at the official NPI Registry.