Individual provider Active NPI

Timothy Bryant White, O.D.

  • Optometrist
  • Mobile, AL
National Provider Identifier
1487602280
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
SB16TA695 Issued in AL
Practice address
2880 Dauphin St
Mobile, AL 36606-2457
Phone
(251) 473-1900
Fax
(251) 470-8943
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X SB16TA695 AL Primary

Addresses

Primary practice location

2880 Dauphin St
Mobile, AL 36606-2457

Mailing address

2880 Dauphin St
Mobile, AL 36606-2457
Phone (251) 473-1900

Other practice location 1

601 Providence Park Dr E
Mobile, AL 36695-4617
Phone (251) 650-2020

Other practice location 2

27961 US Highway 98 Ste 110
Daphne, AL 36526-4702
Phone (251) 928-1941

Other practice location 3

578 Stanton Rd
Mobile, AL 36617-2324
Phone (251) 650-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070226000790 AL Practitioner - Optometry 1355443094 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Premier Health Management IncGroup PAC ID 6608869342, 55 clinicians

Practice addresses (Care Compare)

2880 Dauphin St
Mobile, AL 36606-2457
Phone (251) 473-1900

Merit-based Incentive Payment System (MIPS)

Final score
81.49 of 100Reported as group
Quality
81.75
Promoting interoperability
77
Improvement activities
40
Cost
75.72

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SB16TA695ALMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Management, Inc. Optometrist CurrentSince Dec 22, 2023 Accepting new patients
Premier Health Management, Inc. CurrentSince Dec 22, 2023 Accepting new patients
Family Vision Center, Inc. Optometrist Past Accepting new patients
Jay Lott OD Optometrist Past Accepting new patients

Locations

1302 US Highway 98
Daphne, AL 36526
Phone (251) 410-9000

2880 Dauphin St
Mobile, AL 36606
Phone (251) 341-3368

610 Providence Park Dr E
Ste 101
Mobile, AL 36695
Phone (251) 378-3900

3701 Dauphin St
Mobile, AL 36608
Phone (251) 341-3368

601 Providence Park Dr E
Mobile, AL 36695
Phone (251) 650-2020

610 Providence Park Dr E
Ste 202
Mobile, AL 36695
Phone (251) 635-0919

126 Alabama Ave W
Thomasville, AL 36784
Phone (251) 473-1900

Interoperability endpoints

  • Direct secure messaging: twhite@pm.gwaydirect.com

Organizations & group practices 4

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1487602280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 DAUPHIN ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366062457",
            "telephone_number": "251-473-1900",
            "fax_number": "251-470-8943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 DAUPHIN ST",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366062457",
            "telephone_number": "251-473-1900",
            "fax_number": "251-470-8943"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "601 Providence Park Dr E",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366954617",
            "country_code": "US",
            "telephone_number": "251-650-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "27961 US Highway 98 Ste 110",
            "address_purpose": "LOCATION",
            "city": "Daphne",
            "state": "AL",
            "postal_code": "365264702",
            "country_code": "US",
            "telephone_number": "251-928-1941",
            "fax_number": "251-650-1010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "578 Stanton Rd",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366172324",
            "country_code": "US",
            "telephone_number": "251-650-2020",
            "fax_number": "251-650-1010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "TIMOTHY",
        "middle_name": "BRYANT",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AL",
            "license": "SB16TA695",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.