NPIMap

Individual provider Active NPI

Laura White, DO

  • Pediatrics Physician
  • Lawton, OK
National Provider Identifier
1104053776
Registry record updated Mar 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
5855 Issued in OK
Practice address
4202 SW Lee Blvd
Building B, Suite 100
Lawton, OK 73505-8343
Phone
(580) 368-0808
NPI assigned
Jun 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 5855 OK Primary
Pediatrics Physician 208000000X 5101018070 MI

Addresses

Primary practice location

4202 SW Lee Blvd
Building B, Suite 100
Lawton, OK 73505-8343

Mailing address

4202 SW Lee Blvd
Building B, Suite 100
Lawton, OK 73505-8343
Phone (580) 368-0808

Other identifiers 2

IdentifierTypeStateIssuer
5101018070OtherMIOSTEOPATHIC MEDICAL LICENSE
5315039961OtherMICONTROLLED SUBSTANCE LICENSE

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
5101018070MIMDPediatrics Physician
5855OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Center Past Accepting new patients
Wonder Kids Specialty Pediatrics PLLC Pediatrics Past Accepting new patients
Southwestern Medical Center, LLC Past Accepting new patients
Duncan Regional Hospital, Inc. Past Accepting new patients
Jackson County Memorial Hospital Authority Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: drwhite@wonderkidsped.opdirect.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1245628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1104053776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4202 SW LEE BLVD",
            "address_2": "BUILDING B, SUITE 100",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735058343",
            "telephone_number": "580-368-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4202 SW LEE BLVD",
            "address_2": "BUILDING B, SUITE 100",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735058343",
            "telephone_number": "580-368-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "LAURA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-22",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OK",
            "license": "5855",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "5101018070",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OSTEOPATHIC MEDICAL LICENSE",
            "identifier": "5101018070",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE LICENSE",
            "identifier": "5315039961",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawton, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; 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.