Individual provider Active NPI

Brenna Colleen White, CNM, ARNP

  • Advanced Practice Midwife
  • Orange Park, FL
National Provider Identifier
1164696290
Registry record updated May 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
ARNP9233168 Issued in FL
Practice address
1560 Kingsley Avenue
Suite 4
Orange Park, FL 32073
Phone
(904) 264-1628
Fax
(904) 264-8386
NPI assigned
Apr 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X ARNP 9233168 FL
Advanced Practice Midwife 367A00000X ARNP 228495 NC
Advanced Practice Midwife 367A00000X ARNP9233168 FL Primary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X ARNP9233168 FL

Addresses

Primary practice location

1560 Kingsley Avenue
Suite 4
Orange Park, FL 32073

Mailing address

1560 Kingsley Avenue
Suite 4
Orange Park, FL 32073
Phone (904) 264-1628

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
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
ARNP 9233168FLMDAdvanced Practice Midwife
ARNP 228495NCMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
North Florida Obstetrical and Gynecological Associates PA Past Accepting new patients

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": "1208476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369353600000",
    "number": "1164696290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1560 KINGSLEY AVENUE",
            "address_2": "SUITE 4",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32073",
            "telephone_number": "904-264-1628",
            "fax_number": "904-264-8386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1560 KINGSLEY AVENUE",
            "address_2": "SUITE 4",
            "city": "ORANGE PARK",
            "state": "FL",
            "postal_code": "32073",
            "telephone_number": "904-264-1628",
            "fax_number": "904-264-8386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "BRENNA",
        "middle_name": "COLLEEN",
        "credential": "CNM, ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-18",
        "last_updated": "2013-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "ARNP 9233168",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "NC",
            "license": "ARNP 228495",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "FL",
            "license": "ARNP9233168",
            "primary": true
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "FL",
            "license": "ARNP9233168",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2013; 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.