Michael White Jr.

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704288194 Issued in MI

Practice address

3100 Broadway St.
Suite 400
Detroit, MI 48226-2202

Phone

(586) 335-2006

Fax

(586) 279-3886

NPI assigned

May 23, 2014

Last updated

Jan 12, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 MI

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

Nurse Practitioner

Education

Wayne State University School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Detroit Community Health Connection IncGroup PAC ID 9234021148, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Detroit Community Health Connection, Inc.

  • Federally Qualified Health Center (FQHC)
  • Detroit, MI
  • NPI 1982611562
  Medicare reassignment Care Compare group NPD
• Detroit Community Health Connection, Inc

  dba Dr. Peter Slaughter Health Center

  • Federally Qualified Health Center (FQHC)
  • Detroit, MI
  • NPI 1588137376
  NPD

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1518379650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16134 COLLINSON AVE",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213651",
            "telephone_number": "313-585-3534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 BROADWAY ST.",
            "address_2": "SUITE 400",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482262202",
            "telephone_number": "586-335-2006",
            "fax_number": "586-279-3886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "MICHAEL",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-23",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704288194",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lashondra W White
• Latasha White
• Lauren Elaine White
• Marilyn L White, B.S.ACC
• Michael White
• Michael Thomas White, MD
• Nicholas White
• Nicole Marie White, CPM
• Noni L White
• Olivia White, LLPC

• Psychiatric/Mental Health Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2024; 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.