Russell White, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

9110128 Issued in FL

Practice address

1950 Bluewater Blvd
Suite 100
Niceville, FL 32578-3887

Phone

(850) 897-8081

Fax

(850) 897-1520

NPI assigned

Feb 27, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Florida Surgeons PAGroup PAC ID 2769381391, 336 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HCA Florida Twin Cities Hospital Hospital, Niceville, FL, CCN 100054
• Sacred Heart Hospital on the Emerald Coast Hospital, Miramar Beach, FL, CCN 100292
• North Okaloosa Medical Center Hospital, Crestview, FL, CCN 100122

Merit-based Incentive Payment System (MIPS)

Final score

81.79 of 100Reported as group

Quality

64.42

Promoting interoperability

100

Improvement activities

40

Cost

74.88

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/23855/brand/1/csg/1/fhir/r4
• Direct secure messaging: russell.white.1@19478.direct.athenahealth.com
• Direct secure messaging: russell.white.1@9109.direct.athenahealth.com
• FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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.

• North Florida Surgeons, PA

  • Surgery Physician
  • Jacksonville, FL
  • NPI 1912953290
  Medicare reassignment Care Compare group NPD
• Bluewater Orthopedics PA

  • Orthopaedic Surgery Physician
  • Niceville, FL
  • NPI 1417989617
  Medicare reassignment NPD
• Steven S Donchey Mdpa

  • Internal Medicine Physician
  • Niceville, FL
  • NPI 1962666974
  Medicare reassignment
• Bluewater Orthopedics, P.a.

  • Specialist
  • Crestview, FL
  • NPI 1700119443
  NPD
• North Florida Surgeons, PA

  • Orthopaedic Surgery Physician
  • Gulf Breeze, FL
  • NPI 1871442053
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ascension Sacred Heart Emerald Coast

  • General Acute Care Hospital
  • Miramar Beach, FL
  • NPI 1558391771
  Care Compare affiliation
• Crestview Hospital Company, LLC

  • General Acute Care Hospital
  • Crestview, FL
  • NPI 1104897859
  Care Compare affiliation
• Okaloosa Hospital Inc

  • General Acute Care Hospital
  • Niceville, FL
  • NPI 1891732988
  Care Compare affiliation

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

{
    "created_epoch": "1488153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488153600000",
    "number": "1508306473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 BLUEWATER BLVD",
            "address_2": "SUITE 100",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325783887",
            "telephone_number": "850-897-8081",
            "fax_number": "850-897-1520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 BLUEWATER BLVD",
            "address_2": "SUITE 100",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325783887",
            "telephone_number": "850-897-8081",
            "fax_number": "850-897-1520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "RUSSELL",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-27",
        "last_updated": "2017-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "9110128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• White-Wilson Medical Center, P.a.
• White-Wilson Medical Center, P.a.
• Kathlyn Campbell White, LMHC, LMFT
• Lindsey White
• Rachel Lauren White, APRN
• Courtney Wild
• William Abernathy MD PA
• Frances Viviano Williams, PHARMD
• Kathryn Jean Williams
• Mia Williams, ARNP

• Surgical Physician Assistant in Niceville, FL
• Providers in Niceville, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.