Bronson B White, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A 1121-99 Issued in NM

Practice address

3687 Veterans Dr
Fort Harrison, MT 59636-9703

Phone

(406) 447-7190

NPI assigned

Oct 31, 2006

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Jicarilla IHS Pharmacy

  • Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy
  • Dulce, NM
  • NPI 1124220900
  NPD (past)

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346284800000",
    "number": "1245316280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 181",
            "city": "FORT HARRISON",
            "state": "MT",
            "postal_code": "596360181",
            "telephone_number": "406-447-7190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3687 VETERANS DR",
            "city": "FORT HARRISON",
            "state": "MT",
            "postal_code": "596369703",
            "telephone_number": "406-447-7190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "BRONSON",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2012-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "A 1121-99",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART B",
            "identifier": "HSZ196",
            "state": "NM"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000K3526",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• VA Montana Healthcare Systems
• Kimberly Van Wyk, PHARMD
• Theresa Marie Vonada, PA-C
• David Ernst Weidner, RN
• Kurt E Werner, M.D.
• Todd Will, RPH
• Kalvin Jan Wille, RPH
• Jason Willhardt
• Kelsey Wohlfrom, PHARMD
• Scott C Woller, M.D.

• Family Medicine Physician in Fort Harrison, MT
• Providers in Fort Harrison, MT by specialty
• Family Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2012; 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.