Active NPI
Sally White, M.D.
- Geriatric Medicine (Internal Medicine) Physician
- Brushton, NY
National Provider Identifier
1255525515
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Geriatric Medicine (Internal Medicine) Physician
- License
- 149654-1
- Practice address
- 1214 Washington Street
Brushton, NY 12916 - Phone
- (518) 483-8370
- NPI assigned
- Aug 30, 2007
- Last updated
- Apr 22, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Geriatric Medicine (Internal Medicine) Physician | 207RG0300X | 149654-1 | NY | Primary |
Addresses
Primary practice location
1214 Washington Street
Brushton, NY 12916
Mailing address
2852 State Route 11
North Bangor, NY 12966-2808
Phone (518) 483-8370
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149654-1 | NY | MD | Geriatric Medicine (Internal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366588800000",
"number": "1255525515",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2852 STATE ROUTE 11",
"city": "NORTH BANGOR",
"state": "NY",
"postal_code": "129662808",
"telephone_number": "518-483-8370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1214 WASHINGTON STREET",
"city": "BRUSHTON",
"state": "NY",
"postal_code": "12916",
"telephone_number": "518-483-8370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "SALLY",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-30",
"last_updated": "2013-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Geriatric Medicine",
"state": "NY",
"license": "149654-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brushton, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.