Individual provider Active NPI

Christopher William White, ACNP-BC

  • Acute Care Nurse Practitioner
  • Hamden, CT
National Provider Identifier
1437485182
Registry record updated Jul 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
004229 Issued in CT
Practice address
114 Lincoln St
Hamden, CT 06518-3008
Phone
(203) 887-5682
NPI assigned
Oct 29, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 004229 CT
Acute Care Nurse Practitioner 363LA2100X 004229 CT Primary

Addresses

Primary practice location

114 Lincoln St
Hamden, CT 06518-3008

Mailing address

500 Enterprise Dr Ste 4a
Evercare/Optum
Rocky Hill, CT 06067-3913
Phone (203) 887-5682

Other identifiers 2

IdentifierTypeStateIssuer
D400044363MedicaidCT
D400063711MedicaidCT

Other names 1

  • Mr. Christopher William Donald Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240725002111 CT Order and Referring Only - Nurse Practitioner 5698950947

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
004229CTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Feel Well Health Center of Southington, P.C. Past Accepting new patients
Midstate Medical Group, PC Past Accepting new patients
Southington Urgent Care Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1256774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373414400000",
    "number": "1437485182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 ENTERPRISE DR STE 4A",
            "address_2": "EVERCARE/OPTUM",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060673913",
            "telephone_number": "203-887-5682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 LINCOLN ST",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183008",
            "telephone_number": "203-887-5682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "CHRISTOPHER",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "credential": "ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-29",
        "last_updated": "2013-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "004229",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CT",
            "license": "004229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D400044363",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D400063711",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTOPHER",
            "last_name": "DONALD",
            "middle_name": "WILLIAM",
            "prefix": "MR.",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hamden, CT

Sources for this page

Verify at the official NPI Registry.