NPIMap

Individual provider Active NPI

William Wesley White Jr., D.O.

  • Physical Medicine & Rehabilitation Physician
  • Broomfield, CO
National Provider Identifier
1508397365
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
DR.0066929 Issued in CO
Practice address
11820 Destination Dr
Broomfield, CO 80021-2518
Phone
(720) 848-0000
NPI assigned
Mar 23, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X DR.0066929 CO Primary

Addresses

Primary practice location

11820 Destination Dr
Broomfield, CO 80021-2518

Mailing address

12631 E 17TH Ave # Msf493
Aurora, CO 80045-2527

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210819000999 CO Practitioner - Physical Medicine and Rehabilitation 9133521404 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of North Texas HSC, College of Osteopathic Med, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Physicians IncorporatedGroup PAC ID 3476465667, 3,189 clinicians

Practice addresses (Care Compare)

12605 E 16TH Ave
Uchealth Anschutz Medical Campus
Aurora, CO 80045-2545
Phone (720) 848-0000

Hospital & facility affiliations

  • University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024
  • Broomfield Hospital Inpatient rehabilitation facility, Broomfield, CO, CCN 06T129

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Denver Health and Hospital Authority CurrentSince Oct 25, 2022 Accepting new patients
University Physicians Incorporated Physical Medicine & Rehabilitation Current Accepting new patients
University Physicians, Incorporated CurrentSince Sep 1, 2021 Accepting new patients
Denver Health and Hospital Authority CurrentSince Oct 25, 2022 Accepting new patients
University Physicians, Incorporated CurrentSince Sep 1, 2021 Accepting new patients
Uchealth Broomfield Hospital Past Accepting new patients

Locations

12631 E 17th Ave
#493
Aurora, CO 80045
Phone (303) 724-7408

12605 E 16th Ave
Aurora, CO 80045
Phone (720) 848-0006

13123 E 16th Ave
Aurora, CO 80045
Phone (720) 777-3846

11820 Destination Dr
Ste 3102
Broomfield, CO 80021

11820 Destination Dr
Broomfield, CO 80021
Phone (303) 460-6000

777 Bannock St
Denver, CO 80204

Dept 1061
Denver, CO 80256

Interoperability endpoints

  • Direct secure messaging: wwhite274002@direct.dhha.org

Organizations & group practices 6

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.

Hospital & facility affiliations 29

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

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1490227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1508397365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12631 E 17TH AVE # MSF493",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11820 DESTINATION DR",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800212518",
            "telephone_number": "720-848-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "WILLIAM",
        "middle_name": "WESLEY",
        "name_suffix": "Jr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-23",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CO",
            "license": "DR.0066929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

Verify at the official NPI Registry.