Individual provider Active NPI

Latrelle Lacole White

  • Family Nurse Practitioner
  • Tyler, TX
National Provider Identifier
1275331860
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1192533 Issued in TX
Practice address
2301 Villa Dr
Tyler, TX 75703-1951
Phone
(903) 283-6076
NPI assigned
Mar 7, 2025
Last updated
Mar 18, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 761563 TX
Family Nurse Practitioner 363LF0000X 1192533 TX Primary

Addresses

Primary practice location

2301 Villa Dr
Tyler, TX 75703-1951

Mailing address

2301 Villa Dr
Tyler, TX 75703-1951
Phone (903) 283-6076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250509003242 TX Practitioner - Nurse Practitioner 9638409048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11937 US Hwy 271
Tyler, TX 75708-3154
Phone (903) 877-7200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
761563TXMDRegistered Nurse
1192533TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Health Science Center at Tyler-Facility-Physician CurrentSince May 1, 2025 Accepting new patients
University of Texas Health Science Center at Tyler-Facilty-Physician CurrentSince May 1, 2025 Accepting new patients

Locations

102 W Henderson St
Overton, TX 75684
Phone (903) 834-0201

11937 US Highway 271
Tyler, TX 75708
Phone (903) 877-3451

Organizations & group practices 2

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.

Hospital & facility affiliations 4

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": "1741305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1275331860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 VILLA DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031951",
            "telephone_number": "903-283-6076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 VILLA DR",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757031951",
            "telephone_number": "903-283-6076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "LATRELLE",
        "middle_name": "LACOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-07",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "761563",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1192533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tyler, TX

Sources for this page

Verify at the official NPI Registry.