Anthony Joseph-Lane White

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

5502005604 Issued in MI

Practice address

6601 S Luce Ave
Fremont, MI 49412-7389

Phone

(231) 519-3559

NPI assigned

Nov 26, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1574726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1518503481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 S LUCE AVE",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494127389",
            "telephone_number": "231-519-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 S LUCE AVE",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494127389",
            "telephone_number": "231-519-3559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "ANTHONY",
        "middle_name": "JOSEPH-LANE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-26",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MI",
            "license": "5502005604",
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CO",
            "license": "PTA.0014706",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Weber, RD
• Kenneth Bruce Weddell, DDS
• Elizabeth J. Welsh, M.D.
• Stephen L. Welsh, M.D.
• West Michigan Heart
• Dale Alan Wiersma, MD
• Kara Marie Witmer, NP
• Timothy James Wood, TLPC
• James Yon, MSW
• Janiece Eileen Zahrt, R.D.

• Physical Therapy Assistant in Fremont, MI
• Providers in Fremont, MI by specialty
• Physical Therapy Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2019; 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.