NPIMap

Individual provider Active NPI

Mary White Storm, MD

  • Neurology Physician
  • Lafayette, IN
National Provider Identifier
1265920516
Registry record updated Oct 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
01100126A Issued in IN
Practice address
1701 S Creasy LN
Lafayette, IN 47905-4972
Phone
(765) 502-4400
Fax
(765) 502-4401
NPI assigned
Apr 23, 2018
Last updated
Oct 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2026

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 2026-03021 NC
Neurology Physician 2084N0400X MD61401511 WA
Neurology Physician 2084N0400X 15263-320 WI
Neurology Physician 2084N0400X MD194613 OR
Neurology Physician 2084N0400X 111364 GA
Neurology Physician 2084N0400X 75892 TN
Neurology Physician 2084N0400X 01100126A IN Primary
Neurology Physician 2084N0400X 351860 LA
Hospitalist Physician 208M00000X 75892 TN

Addresses

Primary practice location

1701 S Creasy LN
Lafayette, IN 47905-4972

Mailing address

PO Box 781076
Detroit, MI 48278-1076
Phone (317) 528-4800

Other practice location 1

111 Hospital Dr
Tarboro, NC 27886-2011
Phone (252) 641-7700

Other practice location 2

1000 Medical Center Blvd
Lawrenceville, GA 30046-7694
Phone (678) 312-1000

Other practice location 3

915 6th Ave
Tacoma, WA 98405-4682
Phone (253) 555-5555

Other practice location 4

15790 Paul Vega Md Dr
Hammond, LA 70403-1436
Phone (985) 345-2700

Other practice location 5

130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 224-4000

Other practice location 6

19300 SW 65th Ave
Tualatin, OR 97062-7706
Phone (503) 413-6166

Other practice location 7

410 N State of Franklin Rd Ste 135
Johnson City, TN 37604-6972
Phone (423) 431-2477

Other practice location 8

515 22nd Ave
Monroe, WI 53566-1569
Phone (608) 324-1000

Other identifiers 1

IdentifierTypeStateIssuer
351860OtherLALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, TN, ME3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20230703002864 WA Practitioner - Neurology 1355692880 Reassigns benefits to 3 organizations
I20251219002115 TN Practitioner - HospitalistPractitioner - Neurology 1355692880 Reassigns benefits to 2 organizations
I20260102001075 ME Practitioner - Neurology 1355692880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Neurology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians
Public Hospital Dist No 1 SkagitGroup PAC ID 6800793522, 321 clinicians
York HospitalGroup PAC ID 6406766781, 202 clinicians

Practice addresses (Care Compare)

130 W Ravine Rd
Kingsport, TN 37660-3837
Phone (423) 224-3628

1400 E Kincaid St
Mount Vernon, WA 98274-4127
Phone (360) 428-2500

233 York St a
Neurology Associates of York Hospital
York, ME 03909-1047
Phone (207) 351-3987

410 N State of Franklin Rd
Suite 135
Johnson City, TN 37604-6972
Phone (423) 431-2350

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
75892TNMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Seacoast Pathology Inc Current Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Multicare Health System CurrentSince Feb 7, 2024 Accepting new patients
King County Public Hospital District No. 2 CurrentSince May 23, 2023 Accepting new patients
York Hospital Neurology CurrentSince Jan 5, 2026 Accepting new patients
Multicare Health System CurrentSince Feb 7, 2024 Accepting new patients
King County Public Hospital District No 2 CurrentSince May 23, 2023 Accepting new patients
Multicare Health System Current Accepting new patients
Blue Ridge Medical Management Corporation Neurology CurrentSince Dec 1, 2025 Accepting new patients
Wellmont Medical Associates Inc Hospitalist CurrentSince Dec 1, 2025 Accepting new patients
King County Public Hospital District No 2 Current Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Dec 1, 2025 Accepting new patients

Locations

15 Hospital Dr
York, ME 03909
Phone (207) 351-2478

233 York St
#A
York, ME 03909
Phone (207) 351-3987

1 Medical Park Blvd
Bristol, TN 37620
Phone (423) 390-0451

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

410 N State of Franklin Rd
Ste 135
Johnson City, TN 37604
Phone (423) 431-2350

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

130 W Ravine Rd
Kingsport, TN 37660
Phone (423) 224-3150

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

12039 NE 128th St
Ste 300
Kirkland, WA 98034
Phone (425) 899-3123

315 S K St
Tacoma, WA 98405
Phone (253) 403-1291

Organizations & group practices 14

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 14

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1524441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791331200000",
    "number": "1265920516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781076",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482781076",
            "telephone_number": "317-528-4800",
            "fax_number": "317-865-1479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 S CREASY LN",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479054972",
            "telephone_number": "765-502-4400",
            "fax_number": "765-502-4401"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Tarboro",
            "state": "NC",
            "postal_code": "278862011",
            "country_code": "US",
            "telephone_number": "252-641-7700",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300467694",
            "country_code": "US",
            "telephone_number": "678-312-1000",
            "fax_number": "678-312-3282",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "915 6th Ave",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984054682",
            "country_code": "US",
            "telephone_number": "253-555-5555",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15790 Paul Vega Md Dr",
            "address_purpose": "LOCATION",
            "city": "Hammond",
            "state": "LA",
            "postal_code": "704031436",
            "country_code": "US",
            "telephone_number": "985-345-2700",
            "fax_number": "985-230-6652",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "130 W Ravine Rd",
            "address_purpose": "LOCATION",
            "city": "Kingsport",
            "state": "TN",
            "postal_code": "376603837",
            "country_code": "US",
            "telephone_number": "423-224-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19300 SW 65th Ave",
            "address_purpose": "LOCATION",
            "city": "Tualatin",
            "state": "OR",
            "postal_code": "970627706",
            "country_code": "US",
            "telephone_number": "503-413-6166",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "410 N State of Franklin Rd Ste 135",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376046972",
            "country_code": "US",
            "telephone_number": "423-431-2477",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "515 22nd Ave",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "WI",
            "postal_code": "535661569",
            "country_code": "US",
            "telephone_number": "608-324-1000",
            "fax_number": "608-324-2469",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STORM",
        "first_name": "MARY",
        "middle_name": "WHITE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-23",
        "last_updated": "2026-10-07",
        "certification_date": "2026-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NC",
            "license": "2026-03021",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD61401511",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "15263-320",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "MD194613",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "111364",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TN",
            "license": "75892",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IN",
            "license": "01100126A",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "LA",
            "license": "351860",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TN",
            "license": "75892",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "351860",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

Verify at the official NPI Registry.