Elliott Kingman White

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9116146 Issued in FL

Practice address

540 W Sagamore Ave
Clewiston, FL 33440-3514

Phone

(863) 983-5026

NPI assigned

Jun 11, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Group practices

Hendry County Hospital AuthorityGroup PAC ID 8022912435, 17 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hendry Regional Medical Center Hospital, Clewiston, FL, CCN 101309

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Hendry County Hospital Authority

  dba Hendry Regional Physicians Group

  • Specialist
  • Clewiston, FL
  • NPI 1356360424
  Medicare reassignment Care Compare group
• Kagan Jugan & Associates PA

  • Orthopaedic Surgery Physician
  • Fort Myers, FL
  • NPI 1861450827
  Medicare reassignment
• Hendry County Hospital Authority

  dba Hendry Regional Interventional Pain Therapy

  • Pain Clinic/Center
  • Clewiston, FL
  • NPI 1942576665
  NPD
• Kagan, Jugan & Associates

  • Orthopaedic Surgery Physician
  • Lehigh Acres, FL
  • NPI 1912232299
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hendry County Hospital Authority

  dba Hendry Regional Medical Center

  • Critical Access Hospital
  • Clewiston, FL
  • NPI 1215960315
  Care Compare affiliation

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

{
    "created_epoch": "1654905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1073243218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 SAWGRASS ST",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "334400210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 W SAGAMORE AVE",
            "city": "CLEWISTON",
            "state": "FL",
            "postal_code": "334403514",
            "telephone_number": "863-983-5026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "ELLIOTT",
        "middle_name": "KINGMAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-11",
        "last_updated": "2023-11-16",
        "certification_date": "2023-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marjorie Webster, M.D.
• Wecare Family Homecare Agency LLC
• Dave Drew Weems, DO
• Alan L Weiland, DDS
• Wellington Imaging Associates, P a
• Terrica Williams, CNA
• Carmen Josefa Wilson, MD

• Physician Assistant in Clewiston, FL
• Providers in Clewiston, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.