Charles C White, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

53631 Issued in MA

Practice address

40 Church Ave
Ste 201
Wareham, MA 02571-2093

Phone

(508) 295-3193

Fax

(508) 295-4635

NPI assigned

Jun 23, 2005

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393545600000",
    "number": "1225034317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CHURCH AVE",
            "address_2": "STE 201",
            "city": "WAREHAM",
            "state": "MA",
            "postal_code": "025712093",
            "telephone_number": "508-295-3193",
            "fax_number": "508-295-4635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CHURCH AVE",
            "address_2": "STE 201",
            "city": "WAREHAM",
            "state": "MA",
            "postal_code": "025712093",
            "telephone_number": "508-295-3193",
            "fax_number": "508-295-4635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "CHARLES",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2014-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MA",
            "license": "53631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110071159A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Willow Cove Counseling & Wellness
• Gail Wilson, LMHC

• Specialist in Wareham, MA
• Providers in Wareham, MA by specialty
• Specialist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; 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.