Organization Active NPI

Elizabeth B White MD Inc

  • Internal Medicine Physician
  • Covington, LA
National Provider Identifier
1417094244
Registry record updated Sep 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
09381R Issued in LA
Legal business name
ELIZABETH B WHITE MD INC
Practice address
205 Highland Park PLZ
Covington, LA 70433-7130
Phone
(985) 871-8681
Fax
(985) 871-8684
NPI assigned
Jan 31, 2007
Last updated
Sep 24, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2008

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

Authorized official

Name
Dr. Elizabeth B White, MDNPI 1184604399
Title
Owner
Phone
(985) 871-8681

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 09381R LA Primary
Pediatrics Physician 208000000X 09381R LA

Addresses

Primary practice location

205 Highland Park PLZ
Covington, LA 70433-7130

Mailing address

205 Highland Park PLZ
Covington, LA 70433-7130
Phone (985) 871-8681

Other identifiers 1

IdentifierTypeStateIssuer
5R802CT69OtherLAMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060228000024 LA Part B Supplier - Clinic/Group Practice 6507872611 Receives reassigned benefits from 4 practitioners
Practice locations: Covington, LA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D1059324Elizabeth B White, MD205 Highland Park Plaza, Covington, LA 70433Certificate of waiverApr 17, 2027

National Provider Directory

National Provider Directory

Locations

205 Highland Park Plz
Covington, LA 70433
Phone (985) 809-7171

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1417094244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 HIGHLAND PARK PLZ",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337130",
            "telephone_number": "985-871-8681",
            "fax_number": "985-871-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 HIGHLAND PARK PLZ",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337130",
            "telephone_number": "985-871-8681",
            "fax_number": "985-871-8684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH B WHITE MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "985-871-8681",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "09381R",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "09381R",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "5R802CT69",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.