Individual provider Active NPI

James White Jr., PHD, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Waterford, MI
National Provider Identifier
1376529198
Registry record updated Mar 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704156612 Issued in MI
Practice address
950 N Cass Lake Rd
Suite 107
Waterford, MI 48328-2370
Phone
(248) 681-0623
NPI assigned
Dec 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704156612 MI Primary

Addresses

Primary practice location

950 N Cass Lake Rd
Suite 107
Waterford, MI 48328-2370

Mailing address

950 N Cass Lake Rd
Suite 107
Waterford, MI 48328-2370
Phone (248) 681-0623

Other identifiers 1

IdentifierTypeStateIssuer
4368404MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist, Nurse Practitioner, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
4704156612MIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Seniors Wellness Group of Michigan, P.C. Past Accepting new patients
Advanced Psychiatric Interventions Past Accepting new patients
Arthritis Pain Treatment Center Past Accepting new patients
ENT Surgical Assoc PC 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": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206489600000",
    "number": "1376529198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 N CASS LAKE RD",
            "address_2": "SUITE 107",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282370",
            "telephone_number": "248-681-0623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 N CASS LAKE RD",
            "address_2": "SUITE 107",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483282370",
            "telephone_number": "248-681-0623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHD, NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-22",
        "last_updated": "2008-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704156612",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4368404",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterford, MI

Sources for this page

Verify at the official NPI Registry.