Individual provider Active NPI

Andrea Marie White, D.C.

  • Chiropractor
  • Edwardsville, IL
National Provider Identifier
1316122997
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011093 Issued in IL
Practice address
2 Club Centre CT Ste 3
Edwardsville, IL 62025-3503
Phone
(314) 960-8876
NPI assigned
Jan 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038011093 IL Primary

Addresses

Primary practice location

2 Club Centre CT Ste 3
Edwardsville, IL 62025-3503

Mailing address

7 Santa Fe Dr
Saint Louis, MO 63119-1193
Phone (314) 960-8876

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260616001524 MO Practitioner - Chiropractic 4183701352 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5614 Hampton Ave
Saint Louis, MO 63109-3434

7 Santa Fe Dr
Saint Louis, MO 63119-1193

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hands With Hearts LLC CurrentSince Nov 5, 2023 Accepting new patients

Locations

2 Club Centre Ct
Ste 3
Edwardsville, IL 62025
Phone (314) 960-8876

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1316122997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SANTA FE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631191193",
            "telephone_number": "314-960-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CLUB CENTRE CT STE 3",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253503",
            "telephone_number": "314-960-8876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "ANDREA",
        "middle_name": "MARIE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-02",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwardsville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.