Individual provider Active NPI

Cassandra Johnson White, LMT

  • Contractor
  • Nacogdoches, TX
National Provider Identifier
1508097486
Registry record updated Jul 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
MT032466 Issued in TX
Practice address
7014 North St
Nacogdoches, TX 75965-1144
Phone
(936) 553-4664
Fax
(936) 462-7435
NPI assigned
Jul 27, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X MT032466 TX Primary

Addresses

Primary practice location

7014 North St
Nacogdoches, TX 75965-1144

Mailing address

PO Box 633972
Nacogdoches, TX 75963-3972
Phone (936) 553-4664

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MT032466TXMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248652800000",
    "number": "1508097486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 633972",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759633972",
            "telephone_number": "936-553-4664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7014 NORTH ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651144",
            "telephone_number": "936-553-4664",
            "fax_number": "936-462-7435"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON WHITE",
        "first_name": "CASSANDRA",
        "name_prefix": "Ms.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-07-27",
        "last_updated": "2009-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "TX",
            "license": "MT032466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nacogdoches, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.