Jerry Chad White, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

2007001654 Issued in MO

Practice address

17700 E 39TH St S
Independence, MO 64055-6725

Phone

(816) 393-0250

NPI assigned

May 23, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Kansas Carenow Urgent Care LLC

  • Urgent Care Clinic/Center
  • Leawood, KS
  • NPI 1255883682
  NPD
• Missouri Em-I Medical Services PC

  • Emergency Medicine Physician
  • Fulton, MO
  • NPI 1407243132
  NPD (past)
• Ozarks Medical Center

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641

  Family Medicine

  NPD (past)
• Poplar Bluff Regional Medical Center LLC

  • Rural Health Clinic/Center
  • Malden, MO
  • NPI 1801839147
  NPD (past)
• Poplar Bluff Regional Medical Center, LLC

  • Family Medicine Physician
  • Bloomfield, MO
  • NPI 1023424041
  NPD (past)
• Skaggs Community Hospital Association

  • Family Medicine Physician
  • Branson, MO
  • NPI 1356291298
  NPD (past)
• Skaggs Community Hospital Association

  • Family Medicine Physician
  • Branson West, MO
  • NPI 1467614206
  NPD (past)

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648512000000",
    "number": "1336359017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17700 E 39TH ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556725",
            "telephone_number": "816-393-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17700 E 39TH ST S",
            "city": "INDEPENDENCE",
            "state": "MO",
            "postal_code": "640556725",
            "telephone_number": "816-393-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JERRY",
        "middle_name": "CHAD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2007001654",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204481402",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Megan Wheeler, DPT
• Zachariah L Whertvine, LPC
• Kristina Marie Whisler
• White Crystal Emergency Physicians, LLC
• Alexis Renee White
• Karalee White, CTRS
• Ronnie Whitebear-Short
• Whitworth Optometry, P.C.
• Lee Anne Whitworth, O.D.
• Patrick Glade Whitworth, O.D.

• Family Medicine Physician in Independence, MO
• Providers in Independence, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.