Individual provider Active NPI

Stephen Daniel White, M.D.

  • Orthopaedic Surgery Physician
  • Watkinsville, GA
National Provider Identifier
1497016034
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
79912 Issued in GA
Practice address
1305 Jennings Mill Rd Ste 110
Watkinsville, GA 30677-7241
Phone
(706) 613-5880
NPI assigned
May 30, 2012
Last updated
Jul 27, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 2017-00691 NC
Orthopaedic Surgery Physician 207X00000X 79912 GA Primary

Addresses

Primary practice location

1305 Jennings Mill Rd Ste 110
Watkinsville, GA 30677-7241

Mailing address

3650 J Dewey Gray Cir
Augusta, GA 30909-1867
Phone (706) 863-9797

Other practice location 1

3650 J Dewey Gray Cir
Augusta, GA 30909
Phone (706) 863-9797

Other identifiers 3

IdentifierTypeStateIssuer
1497016034MedicaidNC
2017-00691OtherNCMEDICAL LICENSE
NC3012MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20180720002154 GA Practitioner - Orthopedic Surgery 9537392584 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Medical College of Georgia School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Athens Specialty Care LLCGroup PAC ID 8820349772, 116 clinicians

Practice addresses (Care Compare)

1199 Prince Ave
Athens, GA 30606-2797
Phone (706) 475-1700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.62 of 100Reported as apm
Quality
83.25
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
79912GAMDOrthopaedic Surgery Physician
2017-00691NCMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Athens Specialty Care LLC CurrentSince Aug 1, 2020 Accepting new patients

Locations

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

340 Exchange Blvd
Bethlehem, GA 30620
Phone (678) 963-7171

1305 Jennings Mill Rd
Ste 110
Watkinsville, GA 30677
Phone (706) 613-5880

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1338336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595808000000",
    "number": "1497016034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3650 J DEWEY GRAY CIR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091867",
            "telephone_number": "706-863-9797",
            "fax_number": "706-860-7686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 JENNINGS MILL RD STE 110",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306777241",
            "telephone_number": "706-613-5880"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3650 J Dewey Gray Cir",
            "address_purpose": "LOCATION",
            "city": "Augusta",
            "state": "GA",
            "postal_code": "30909",
            "country_code": "US",
            "telephone_number": "706-863-9797",
            "fax_number": "706-863-7686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "STEPHEN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-30",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NC",
            "license": "2017-00691",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "GA",
            "license": "79912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497016034",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "2017-00691",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NC3012",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkinsville, GA

Sources for this page

Verify at the official NPI Registry.