Individual provider Active NPI

Christopher Luke White, M.D.

  • General Practice Physician
  • Memphis, TN
National Provider Identifier
1316987639
Registry record updated Apr 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
MD0000036971 Issued in TN
Practice address
2911 Brunswick Rd
Memphis, TN 38133-4105
Phone
(901) 377-4722
Fax
(901) 373-0984
NPI assigned
Jun 7, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X MD0000036971 TN Primary

Addresses

Primary practice location

2911 Brunswick Rd
Memphis, TN 38133-4105

Mailing address

268 E Chickasaw Pkwy
Memphis, TN 38111-2538
Phone (901) 755-9905

Other identifiers 1

IdentifierTypeStateIssuer
MD0000036971OtherTNMEDICAL LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070205000593 TN Practitioner - Psychiatry 4981606936 Practice locations: Memphis, TN

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000036971TNMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Psycare LLC PastSince Dec 1, 2018 Accepting new patients
Professional Health Services of Jackson PastSince Feb 22, 2012 Accepting new patients
Memphis Psychiatric and Addiction Clinic, PC PastSince Dec 23, 1996 Accepting new patients
Uhs of Lakeside LLC Past Accepting new patients

Organizations & group practices 4

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367280000000",
    "number": "1316987639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "268 E CHICKASAW PKWY",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381112538",
            "telephone_number": "901-755-9905",
            "fax_number": "901-755-9982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2911 BRUNSWICK RD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381334105",
            "telephone_number": "901-377-4722",
            "fax_number": "901-373-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "CHRISTOPHER",
        "middle_name": "LUKE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2013-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "TN",
            "license": "MD0000036971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD0000036971",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.