Individual provider Active NPI

Diane White, M.D.

  • Addiction Medicine (Internal Medicine) Physician
  • Whiteville, NC
National Provider Identifier
1093778011
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0401X
License
BW1823221 Issued in NC
Practice address
603 Pecan Lane
Whiteville, NC 28472-2835
Phone
(310) 780-3444
Fax
(310) 780-3444
NPI assigned
Apr 10, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X BW1823221 NC
Addiction Medicine (Internal Medicine) Physician 207RA0401X BW1823221 NC Primary
Addiction Psychiatry Physician 2084P0802X BW1823221X NC

Addresses

Primary practice location

603 Pecan Lane
Whiteville, NC 28472-2835

Mailing address

2914 N Elm St # 183
Lumberton, NC 28358-2981
Phone (310) 780-3444

Other practice location 1

850 Jake Alexander Blvd W Ste G
Salisbury, NC 28147-1224
Phone (310) 780-3444

Other identifiers 1

IdentifierTypeStateIssuer
1093778011MedicaidNC

Other names 1

  • Dr. Diane White Professional name

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1093778011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2914 N ELM ST # 183",
            "city": "LUMBERTON",
            "state": "NC",
            "postal_code": "283582981",
            "telephone_number": "310-780-3444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 PECAN LANE",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284722835",
            "telephone_number": "310-780-3444",
            "fax_number": "310-780-3444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 Jake Alexander Blvd W Ste G",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "NC",
            "postal_code": "281471224",
            "country_code": "US",
            "telephone_number": "310-780-3444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NC",
            "license": "BW1823221",
            "primary": false
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "NC",
            "license": "BW1823221",
            "primary": true
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "NC",
            "license": "BW1823221X",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093778011",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "WHITE",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Whiteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.