Active NPI
K. Kittredge White, PA-C
- Physician Assistant
- Jamaica Plain, MA
National Provider Identifier
1487756938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 2196
- Practice address
- 1153 Centre St Ste 51
Jamaica Plain, MA 02130-3446 - Phone
- (617) 983-4570
- NPI assigned
- Sep 5, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2196 | MA | Primary |
Addresses
Primary practice location
1153 Centre St Ste 51
Jamaica Plain, MA 02130-3446
Mailing address
1153 Center Street
Suite 51
Boston, MA 02130-3446
Phone (617) 983-4570
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2196 | MA | MD | Foot Surgery Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Massachusetts Institute of Technology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Cambridge, MA
- NPI 1346308723
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225670400000",
"number": "1487756938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1153 CENTER STREET",
"address_2": "SUITE 51",
"city": "BOSTON",
"state": "MA",
"postal_code": "021303446",
"telephone_number": "617-983-4570"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1153 CENTRE ST STE 51",
"city": "JAMAICA PLAIN",
"state": "MA",
"postal_code": "021303446",
"telephone_number": "617-983-4570"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "K. KITTREDGE",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-05",
"last_updated": "2008-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "2196",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jamaica Plain, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.