Individual provider Active NPI

Robert White, DC

  • Chiropractor
  • Winter Garden, FL
National Provider Identifier
1114557386
Registry record updated May 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
13033 Issued in FL
Practice address
13530 Glynshel Dr
Winter Garden, FL 34787-5000
Phone
(321) 231-9634
NPI assigned
Jan 16, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 13033 FL Primary

Addresses

Primary practice location

13530 Glynshel Dr
Winter Garden, FL 34787-5000

Mailing address

PO Box 579
Oakland, FL 34760-0579
Phone (407) 614-7609

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200714000787 FL Practitioner - Chiropractic 1052734779

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13033FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Reformation Chiropractic PLLC Chiropractor CurrentSince Apr 1, 2020 Accepting new patients

Locations

301 S Tubb St
Ste F2
Oakland, FL 34760
Phone (407) 614-7609

Organizations & group practices 1

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": "1579132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590278400000",
    "number": "1114557386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 579",
            "city": "OAKLAND",
            "state": "FL",
            "postal_code": "347600579",
            "telephone_number": "407-614-7609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13530 GLYNSHEL DR",
            "city": "WINTER GARDEN",
            "state": "FL",
            "postal_code": "347875000",
            "telephone_number": "321-231-9634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "ROBERT",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-16",
        "last_updated": "2020-05-24",
        "certification_date": "2020-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "13033",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Garden, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.