Individual provider Active NPI

Bethany White III, AGNP-C

  • Adult Health Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1306395264
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
21750 Issued in TN
Practice address
1128 E Weisgarber Rd
Suite 100
Knoxville, TN 37909-2674
Phone
(865) 579-0552
Fax
(865) 579-1154
NPI assigned
Oct 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 21750 TN Primary
Gerontology Nurse Practitioner 363LG0600X 21750 TN

Addresses

Primary practice location

1128 E Weisgarber Rd
Suite 100
Knoxville, TN 37909-2674

Mailing address

1128 E Weisgarber Rd
Suite 100
Knoxville, TN 37909-2674
Phone (865) 579-0552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, IN, WI, KS4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20170104000383 TN Practitioner - Nurse Practitioner 1557642642 Reassigns benefits to 3 organizations
I20200422002063 IN Practitioner - Nurse Practitioner 1557642642 Reassigns benefits to 2 organizations
I20250610000406 WI Practitioner - Nurse Practitioner 1557642642 Reassigns benefits to 1 organization
I20250621000061 KS Practitioner - Nurse Practitioner 1557642642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Informe Healthcare in LLCGroup PAC ID 9537407770, 14 clinicians
Informe Healthcare LLCGroup PAC ID 8123375474, 12 clinicians
Informe Healthcare Il LLCGroup PAC ID 8123448784, 24 clinicians

Practice addresses (Care Compare)

1121 E Lasalle Ave
South Bend, IN 46617-3321
Phone (574) 475-7157

17475 Dugdale Dr
South Bend, IN 46635-1545
Phone (574) 247-7500

502 Roseport Rd
Elwood, KS 66024-7801
Phone (913) 348-4453

7970 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 435-6100

801 Braxton PL
Madison, WI 53715-1415
Phone (414) 242-5468

Merit-based Incentive Payment System (MIPS)

Final score
95.23 of 100Reported as group
Quality
90
Improvement activities
40
Cost
82.96

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21750TNMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pain Consultants of East Tennessee, PLLC CurrentSince Oct 15, 2016 Accepting new patients
Informe Healthcare in, LLC CurrentSince Jun 22, 2025 Accepting new patients
Informe Healthcare Il LLC CurrentSince Mar 20, 2025 Accepting new patients
Informe Healthcare Specialists, LLC CurrentSince Apr 12, 2021 Accepting new patients
Informe Healthcare TN, LLC CurrentSince May 1, 2020 Accepting new patients
Behavioral Medicine Institute PC PastSince Sep 23, 2012 Accepting new patients

Locations

7970 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 435-2607

745 N Swope St
Greenfield, IN 46140
Phone (317) 462-9221

8800 Virginia Pl
Merrillville, IN 46410
Phone (219) 736-1310

17475 Dugdale Dr
South Bend, IN 46635
Phone (574) 247-7500

1121 E Lasalle Ave
South Bend, IN 46617
Phone (574) 287-6501

709 Walnut St
Chattanooga, TN 37402
Phone (423) 266-7721

1250 Tennova Medical Way
Knoxville, TN 37909
Phone (800) 324-4777

220 Fort Sanders West Blvd
Ste 308
Knoxville, TN 37922
Phone (865) 579-0552

1540 Member Ln
Ste 100
Knoxville, TN 37909
Phone (865) 579-0552

1128 E Weisgarber Rd
Ste 100
Knoxville, TN 37909
Phone (865) 251-5215

1444 Old Weisgarber Rd
Knoxville, TN 37909
Phone (865) 500-6665

575 Oak Ridge Tpke
Ste 110
Oak Ridge, TN 37830
Phone (865) 579-0552

6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300

801 Braxton Pl
Madison, WI 53715
Phone (608) 251-1010

2741 W Layton Ave
Ste 106
Milwaukee, WI 53221

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1475452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1306395264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1128 E WEISGARBER RD",
            "address_2": "SUITE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092674",
            "telephone_number": "865-579-0552",
            "fax_number": "865-579-1154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1128 E WEISGARBER RD",
            "address_2": "SUITE 100",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092674",
            "telephone_number": "865-579-0552",
            "fax_number": "865-579-1154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "BETHANY",
        "name_suffix": "III",
        "credential": "AGNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-03",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TN",
            "license": "21750",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TN",
            "license": "21750",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.