Individual provider Active NPI

Corey White, DO, MBA

  • Neurology Physician
  • Olympia, WA
National Provider Identifier
1154610814
Registry record updated Jan 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
OP60739312 Issued in WA
Practice address
525 Lilly Rd NE
Olympia, WA 98506-5101
Phone
(360) 413-8550
Fax
(360) 413-8827
NPI assigned
Apr 4, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurocritical Care Physician 2084A2900X OP60739312 WA
Neurology Physician 2084N0400X OP60739312 WA Primary

Addresses

Primary practice location

525 Lilly Rd NE
Olympia, WA 98506-5101

Mailing address

PO Box 3360
Portland, OR 97208-3360

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA, TX3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20150606000040 OR Practitioner - Neurology 2961723663 Reassigns benefits to 1 organization
I20170811001881 WA Practitioner - NeurologyPractitioner - Other (Physician) 2961723663 Reassigns benefits to 11 organizations
I20200922000707 TX Practitioner - Neurology 2961723663 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health and Services WashingtonGroup PAC ID 0345139929, 778 clinicians
Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians
Providence Health and Services- WashingtonGroup PAC ID 1557408176, 219 clinicians
Providence Health and Services - WashingtonGroup PAC ID 2860552973, 266 clinicians
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians
Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians
Providence Health and Services WashingtonGroup PAC ID 6709782600, 480 clinicians

Practice addresses (Care Compare)

Olympia, WA 98502

413 Lilly Rd NE
Olympia, WA 98506-5133

615 Lilly Rd NE
Suite 220
Olympia, WA 98506-5137
Phone (360) 493-4015

Hospital & facility affiliations

  • Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024
  • Providence Centralia Hospital Hospital, Centralia, WA, CCN 500019
  • Grays Harbor Community Hospital Hospital, Aberdeen, WA, CCN 500031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Master of Business Administration

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Washington CurrentSince Nov 9, 2019 Accepting new patients
Providence Health & Services - Washington CurrentSince Nov 9, 2019 Accepting new patients
Providence Health & Services Mt CurrentSince Nov 9, 2019 Accepting new patients
Providence Health & Services Washington Current Accepting new patients
Providence Health & Services Oregon CurrentSince Nov 9, 2019 Accepting new patients
Southeast Alaska Regional Health Consortium CurrentSince Sep 14, 2020 Accepting new patients
Providence Medical Institute CurrentSince Nov 9, 2019 Accepting new patients
Providence Health & Services- Washington CurrentSince Nov 9, 2019 Accepting new patients
South East Alaska Regional Health Consortium CurrentSince Sep 14, 2020 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Swedish Health Services CurrentSince May 10, 2022 Accepting new patients
Providence Health & Services- Washington CurrentSince Nov 9, 2019 Accepting new patients
Grays Harbor County Public Hospital District No. 1 CurrentSince Aug 15, 2017 Accepting new patients
Providence Health & Services Washington CurrentSince Aug 1, 2017 Accepting new patients
Providence Health & Services Oregon CurrentSince Nov 1, 2018 Accepting new patients
Providence Health & Services Washington CurrentSince Aug 1, 2017 Accepting new patients
Providence Health & Services Washington CurrentSince Aug 1, 2017 Accepting new patients
Providence Health & Services Oregon CurrentSince Nov 1, 2018 Accepting new patients
Southeast Alaska Regional Health Consortium Current Accepting new patients
Grays Harbor County Public Hospital District No 1 Current Accepting new patients
Providence Health & Services Oregon CurrentSince Nov 9, 2019 Accepting new patients
Grays Harbor County Public Hospital District No 1 CurrentSince Aug 15, 2017 Accepting new patients
Providence Health & Services - Washington CurrentSince Nov 9, 2019 Accepting new patients
Providence Medical Institute CurrentSince Nov 9, 2019 Accepting new patients
Providence Health & Services Washington CurrentSince Nov 9, 2019 Accepting new patients
Providence Medical Institute Past Accepting new patients

Locations

37 Chilkat Ave
Haines, AK 99827
Phone (907) 463-4040

3100 Channel Dr
Ste 300
Juneau, AK 99801
Phone (907) 463-4000

222 Tongass Dr
Sitka, AK 99835
Phone (907) 966-8423

4101 Torrance Blvd
Torrance, CA 90503
Phone (310) 540-7676

10150 SE 32nd Ave
Portland, OR 97222
Phone (503) 215-4202

7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800

600 E Main St
Elma, WA 98541
Phone (360) 346-2222

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

1018 Capitol Way S
Ste 300
Olympia, WA 98501
Phone (360) 486-6508

615 Lilly Rd NE
Ste 220
Olympia, WA 98506
Phone (360) 486-6150

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

1905 SE 164th Ave
Vancouver, WA 98683
Phone (360) 836-3396

380 Chase Ave
Walla Walla, WA 99362
Phone (509) 526-3333

Interoperability endpoints

  • Direct secure messaging: cwhite815446@wm.providencedirect.org

Organizations & group practices 26

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.

View all 26

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1301875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548201600000",
    "number": "1154610814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3360",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972083360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 LILLY RD NE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065101",
            "telephone_number": "360-413-8550",
            "fax_number": "360-413-8827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "COREY",
        "credential": "DO, MBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-04",
        "last_updated": "2019-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084A2900X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurocritical Care",
            "state": "WA",
            "license": "OP60739312",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "OP60739312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.