Active NPI
Brandon M White, M.D.
- Pediatrics Physician
- Spokane, WA
National Provider Identifier
1396988069
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD61352935
- Practice address
- 1919 S Grand Blvd
Spokane, WA 99203-2347 - Phone
- (509) 747-3081
- Fax
- (509) 247-2938
- NPI assigned
- Apr 10, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | AFE113787 | CA | |
| Pediatrics Physician | 208000000X | C1-0010229 | DE | |
| Pediatrics Physician | 208000000X | MD61352935 | WA | Primary |
Addresses
Primary practice location
1919 S Grand Blvd
Spokane, WA 99203-2347
Mailing address
PO Box 421
Liberty Lake, WA 99019-0421
Phone (866) 747-2455
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AFE113787 | CA | MD | Pediatrics Physician |
| C1-0010229 | DE | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Health & Services Washington | Current | Accepting new patients | |
| Providence Health & Services - Washington | Past | Accepting new patients | |
| Providence Health & Services - Wa | Past | Accepting new patients |
Locations
1200 E Columbia Ave
Colville, WA 99114
Phone (509) 684-3701
1919 S Grand Blvd
Spokane, WA 99203
Phone (509) 747-3081
Organizations & group practices 3
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.
-
- Pulmonary Disease Physician
- Spokane, WA
- NPI 1194099390
-
- General Acute Care Hospital
- Spokane, WA
- NPI 1144471715
-
- Substance Use Disorder Rehabilitation Hospital Unit
- Hoquiam, WA
- NPI 1043374119
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704412800000",
"number": "1396988069",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 421",
"city": "LIBERTY LAKE",
"state": "WA",
"postal_code": "990190421",
"telephone_number": "866-747-2455",
"fax_number": "509-227-7070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 S GRAND BLVD",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992032347",
"telephone_number": "509-747-3081",
"fax_number": "509-247-2938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "BRANDON",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-10",
"last_updated": "2024-01-05",
"certification_date": "2024-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "AFE113787",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "DE",
"license": "C1-0010229",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "MD61352935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.