Active NPI
John Joseph White, MD
- Surgery Physician
- Decatur, IL
National Provider Identifier
1184606527
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- Practice address
- 1750 E Lake Shore Dr
Ste 200
Decatur, IL 62521-3809 - Phone
- (217) 428-6300
- Fax
- (217) 428-6322
- NPI assigned
- Nov 18, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | IL | Primary |
Addresses
Primary practice location
1750 E Lake Shore Dr
Ste 200
Decatur, IL 62521-3809
Mailing address
1750 E Lake Shore Dr
Ste 200
Decatur, IL 62521-3809
Phone (217) 428-6300
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CI8411 | Other | MEDICARE TRAVELERS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193356800000",
"number": "1184606527",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1750 E LAKE SHORE DR",
"address_2": "STE 200",
"city": "DECATUR",
"state": "IL",
"postal_code": "625213809",
"telephone_number": "217-428-6300",
"fax_number": "217-428-6322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1750 E LAKE SHORE DR",
"address_2": "STE 200",
"city": "DECATUR",
"state": "IL",
"postal_code": "625213809",
"telephone_number": "217-428-6300",
"fax_number": "217-428-6322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "JOHN",
"middle_name": "JOSEPH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-18",
"last_updated": "2007-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE TRAVELERS",
"identifier": "CI8411",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Decatur, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.