Individual provider Active NPI

Brytani Ladawn White, PA-C

  • Physician Assistant
  • Canon City, CO
National Provider Identifier
1437883402
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
715 S 9TH St
Canon City, CO 81212-4911
Phone
(719) 269-8820
NPI assigned
Jul 14, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CO Primary

Addresses

Primary practice location

715 S 9TH St
Canon City, CO 81212-4911

Mailing address

715 S 9TH St
Canon City, CO 81212-4911
Phone (719) 269-8820

Other practice location 1

8401 S Chambers Rd
Parker, CO 80134-9498
Phone (303) 373-2008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20240409002800 CO Practitioner - Physician Assistant 4789022880 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Button Family Practice PCGroup PAC ID 0840225413, 9 clinicians

Practice addresses (Care Compare)

715 S 9TH St
Canon City, CO 81212-4911
Phone (269) 753-4125

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Vista Health Center LLC PastSince Jul 1, 2022 Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8078/brand/1/csg/1/fhir/r4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1657756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1437883402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 S 9TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124911",
            "telephone_number": "719-269-8820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 S 9TH ST",
            "city": "CANON CITY",
            "state": "CO",
            "postal_code": "812124911",
            "telephone_number": "719-269-8820"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8401 S Chambers Rd",
            "address_purpose": "LOCATION",
            "city": "Parker",
            "state": "CO",
            "postal_code": "801349498",
            "country_code": "US",
            "telephone_number": "303-373-2008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "BRYTANI",
        "middle_name": "LADAWN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-14",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canon City, CO

Sources for this page

Verify at the official NPI Registry.