Individual provider Active NPI

Carol Ann White, M.D.

  • Vascular Surgery Physician
  • Morgantown, WV
National Provider Identifier
1417028887
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
20351 Issued in WV
Practice address
1311 Pineview Dr
Morgantown, WV 26505-0485
Phone
(304) 598-7546
NPI assigned
Nov 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20351 WV
General Practice Physician 208D00000X 20351 WV
Specialist 174400000X 20351 WV
Vascular Surgery Physician 2086S0129X 20351 WV Primary

Addresses

Primary practice location

1311 Pineview Dr
Morgantown, WV 26505-0485

Mailing address

234 Carmichaels Rd
Carmichaels, PA 15320-2548
Phone (724) 809-1325

Other practice location 1

230 Hospital Plz
Weston, WV 26452-8558
Phone (304) 517-1272

Other identifiers 1

IdentifierTypeStateIssuer
1806879000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20100310000493 WV Practitioner - Vascular SurgeryPractitioner - Emergency Medicine 5890830293

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. White'S Vein Center Vascular Surgery CurrentSince Dec 19, 2017 Accepting new patients
Emergency Medicine Physicians of Brooke County, PLLC Emergency Medicine Past Accepting new patients

Locations

1311 Pineview Dr
Morgantown, WV 26505
Phone (304) 598-7546

1311 Pineview Dr
Ste 200
Morgantown, WV 26505
Phone (304) 225-7549

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": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1417028887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 CARMICHAELS RD",
            "city": "CARMICHAELS",
            "state": "PA",
            "postal_code": "153202548",
            "telephone_number": "724-809-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 PINEVIEW DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265050485",
            "telephone_number": "304-598-7546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "230 Hospital Plz",
            "address_purpose": "LOCATION",
            "city": "Weston",
            "state": "WV",
            "postal_code": "264528558",
            "country_code": "US",
            "telephone_number": "304-517-1272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "20351",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "WV",
            "license": "20351",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WV",
            "license": "20351",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "WV",
            "license": "20351",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1806879000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.