Individual provider Active NPI

Richard B White, MD

  • Family Medicine Physician
  • Windsor, VT
National Provider Identifier
1467448621
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
042-0007579 Issued in VT
Practice address
289 County Rd
Windsor, VT 05089-9000
Phone
(802) 674-7300
Fax
(802) 674-7314
NPI assigned
Sep 23, 2005
Last updated
Dec 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 042-0007579 VT Primary

Addresses

Primary practice location

289 County Rd
Windsor, VT 05089-9000

Mailing address

617 Riverside Ave
Burlington, VT 05401-1601
Phone (802) 864-6309

Other identifiers 1

IdentifierTypeStateIssuer
0006486MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20050930000213 VT Practitioner - Family PracticePractitioner - Pediatric Medicine 5991730632 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
042-0007579VTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Center, Inc CurrentSince Sep 5, 2013 Accepting new patients
Northwestern Medical Center, Inc. Current Accepting new patients
Northwestern Medical Center Inc CurrentSince Sep 5, 2013 Accepting new patients
Community Health Centers of Burlington Inc CurrentSince Feb 6, 2017 Accepting new patients
Community Health Centers of Burlington Inc Family Medicine CurrentSince Feb 6, 2017 Accepting new patients
Northwestern Medical Center, Inc. Past Accepting new patients

Locations

617 Riverside Ave
Burlington, VT 05401
Phone (802) 264-8158

789 Pine St
Burlington, VT 05401
Phone (802) 264-1052

927 Ethan Allen Hwy
Unit 2
Milton, VT 05468
Phone (802) 524-8911

133 Fairfield St
Saint Albans, VT 05478
Phone (802) 524-1227

260 Crest Rd
Ste 101
Saint Albans, VT 05478
Phone (802) 524-1223

260 Crest Rd
Ste 102
Saint Albans, VT 05478
Phone (802) 524-1064

3 Crest Rd
Saint Albans, VT 05478
Phone (802) 524-4554

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482192000000",
    "number": "1467448621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 RIVERSIDE AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011601",
            "telephone_number": "802-864-6309",
            "fax_number": "802-860-4313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 COUNTY RD",
            "city": "WINDSOR",
            "state": "VT",
            "postal_code": "050899000",
            "telephone_number": "802-674-7300",
            "fax_number": "802-674-7314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "RICHARD",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2016-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "042-0007579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006486",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, VT

Sources for this page

Verify at the official NPI Registry.