Kevin M White, DO
Individual provider Active NPI Internal Medicine Physician · Spring Park, MN
NPI 1285634162 · NPPES record last updated Mar 16, 2010
Key facts
- NPI
- 1285634162
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 40200 (MN)
- Practice address
- 4695 Shoreline Dr
Spring Park, MN 55384-9715 - Phone
- (952) 442-7895
- Fax
- (952) 442-7894
- NPI assigned
- Jul 21, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Des Moines University of Osteopathic Medicine and Health Sciences, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ridgeview Medical Center
Practice addresses (Care Compare)
500 S Maple St
Waconia, MN 55387-1752
Phone (952) 442-2191
7907 Powers Blvd
Chanhassen, MN 55317-9502
Phone (952) 934-0570
Hospital & facility affiliations
- Ridgeview Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060118000898 | MN | Practitioner - Internal Medicine | 6406870310 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ridgeview Medical Center | Current | Accepting new patients | |
| Ridgeview Medical Center | Current |
Accepting new patients | |
| Sibley Medical Center | Current |
Accepting new patients | |
| Ridgeview Medical Center | Current |
Accepting new patients | |
| Ridgeview Clinics | Past | Accepting new patients | |
| Emergency Physicians & Consultants, PA | Past | Accepting new patients | |
| Carlson Chiropractic Health and Healing Inc. | Past |
Accepting new patients | |
| Ridgeview Medical Center | Past | Accepting new patients |
Locations
601 W Chandler St
Arlington, MN 55307
Phone (507) 964-2271
7907 Powers Blvd
Chanhassen, MN 55317
Phone (952) 934-0570
2200 Commerce Blvd
Mound, MN 55364
Phone (952) 495-2000
4695 Shoreline Dr
Spring Park, MN 55384
Phone (952) 442-7890
500 S Maple St
Waconia, MN 55387
Phone (612) 442-2191
560 S Maple St
Ste 220
Waconia, MN 55387
Phone (952) 442-8011
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 40200 | MN | Yes |
Addresses
Primary practice location
4695 Shoreline Dr
Spring Park, MN 55384-9715
Mailing address
4695 Shoreline Dr
Spring Park, MN 55384-9715
Phone (952) 442-7895
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 677015100 | Medicaid | MN | |
| 40200 | Other | MN | DO LICENSE |
Other providers in Spring Park, MN
- Mary Moe Trites
- Aaron Tsay
- Urology Associates, LTD.
- Dantel Weaver
- Benedict J Weinbeck III
- Ashley Nicole Wurdeman
All providers in Spring Park, MN · Internal Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 16, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.