Individual provider Active NPI

Mark James White

  • Non-emergency Medical Transport (VAN)
  • Port Huron, MI
National Provider Identifier
1124796461
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
License
5803001724 Issued in MI
Practice address
2026 Lapeer Ave Ste 1
Port Huron, MI 48060-4156
Phone
(810) 969-7899
Fax
(810) 432-8081
NPI assigned
Sep 1, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X 5803001724 MI Primary

Addresses

Primary practice location

2026 Lapeer Ave Ste 1
Port Huron, MI 48060-4156

Mailing address

2026 Lapeer Ave Ste 1
Port Huron, MI 48060-4156
Phone (810) 969-7899

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5803001724MIMDNon-emergency Medical Transport (VAN)

NPI Registry JSON

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1124796461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2026 LAPEER AVE STE 1",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480604156",
            "telephone_number": "810-969-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2026 LAPEER AVE STE 1",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480604156",
            "telephone_number": "810-969-7899",
            "fax_number": "810-432-8081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "MARK",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-01",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "MI",
            "license": "5803001724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.