Russell William White, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1141269 Issued in FL

Practice address

6015 Pointe West Blvd
Bradenton, FL 34209-5525

Phone

(941) 782-0200

NPI assigned

Feb 5, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/4692/brand/27/csg/1/fhir/r4
• Direct secure messaging: russell.white@hca4.eclinicaldirectplus.com

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.

• Coastal Orthopedics & Sports Medicine of Southwest Florida PA

  • Orthopaedic Surgery Physician
  • Bradenton, FL
  • NPI 1285740720
  Medicare reassignment NPD
• West Florida Trauma Network, LLC

  • Trauma Surgery Physician
  • Bradenton, FL
  • NPI 1902198948
  Medicare reassignment
• West Florida Cardiology Network, LLC

  • Cardiovascular Disease Physician
  • Saint Petersburg, FL
  • NPI 1801198023
  NPD (past)

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

{
    "created_epoch": "1517788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518393600000",
    "number": "1174022206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6015 POINTE WEST BLVD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342095525",
            "telephone_number": "941-792-1404",
            "fax_number": "941-761-0712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 POINTE WEST BLVD",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342095525",
            "telephone_number": "941-782-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "RUSSELL",
        "middle_name": "WILLIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-05",
        "last_updated": "2018-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "1141269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BCBS",
            "identifier": "0IVK6",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Matthew White
• Michaela White, MS, CF-SLP
• Nathan James White, PH.D.
• Oceanna White, ARNP
• Richard Armando White, LCSW
• Virginia White
• Mark Adam Whited
• Kerri Anne Whitehead, M.S.P.T., A.T.C.
• Charles Whitfield, M.ED
• Maria D Whitney, RN

• Physician Assistant in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.