Individual provider Active NPI

Michelle Marie White

  • Psychiatric/Mental Health Nurse Practitioner
  • Fort Worth, TX
National Provider Identifier
1356029573
Registry record updated Jul 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1129242 Issued in TX
Practice address
801 7TH Ave
Fort Worth, TX 76104-2796
Phone
(682) 885-4000
NPI assigned
Jul 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 959402 TX
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1129242 TX Primary

Addresses

Primary practice location

801 7TH Ave
Fort Worth, TX 76104-2796

Mailing address

1207 Roaring Springs Rd
Fort Worth, TX 76114-4488
Phone (817) 774-7415

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250909001200 TX Practitioner - Nurse Practitioner 3375045255 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1207 Roaring Springs Rd
Fort Worth, TX 76114-4488

7000 Calmont Ave
Suite 150
Fort Worth, TX 76116-4192

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
959402TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cook Children'S Physician Network CurrentSince Jul 27, 2025 Accepting new patients
Cook Children'S Physician Network Current Accepting new patients

Locations

801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054

4100 W University Dr
Prosper, TX 75078
Phone (682) 303-4200

136 El Chico Trl
Ste 102
Willow Park, TX 76087
Phone (817) 441-5412

Interoperability endpoints

  • Direct secure messaging: mwhite161955@cookchildrens.direct-ci.com

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": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1356029573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1207 ROARING SPRINGS RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761144488",
            "telephone_number": "817-774-7415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 7TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042796",
            "telephone_number": "682-885-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-07-18",
        "certification_date": "2023-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "959402",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1129242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.