NPIMap

Individual provider Active NPI

Jeffery Randall White, M.D.

  • Vascular & Interventional Radiology Physician
  • Waco, TX
National Provider Identifier
1558564641
Registry record updated Aug 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
P2932 Issued in TX
Practice address
6901 Medical Pkwy
Radiology Department
Waco, TX 76712-7910
Phone
(254) 751-4299
Fax
(903) 663-7394
NPI assigned
Jun 7, 2007
Last updated
Aug 19, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X P2932 TX Primary

Addresses

Primary practice location

6901 Medical Pkwy
Radiology Department
Waco, TX 76712-7910

Mailing address

4777 US Highway 259
Longview, TX 75605-7668
Phone (903) 663-7393

Other identifiers 1

IdentifierTypeStateIssuer
302494501MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20120723000417 TX Practitioner - Diagnostic Radiology 4688830532 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Medical Branch at Galveston, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Texas Radiological Associates PAGroup PAC ID 4385740141, 61 clinicians
Waco Cardiology AssociatesGroup PAC ID 2860464948, 22 clinicians

Practice addresses (Care Compare)

6901 Medical Pkwy
Waco, TX 76712-7910
Phone (254) 751-4000

7125 New Sanger Ave
Suite a
Waco, TX 76712-4054
Phone (254) 399-5400

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Central Texas Radiological Associates PA CurrentSince Jan 1, 2007 Accepting new patients
Waco Cardiology Associates CurrentSince Dec 5, 2025 Accepting new patients

Locations

400 N Brown St
Hamilton, TX 76531
Phone (254) 386-1600

3206 4th St
Longview, TX 75605
Phone (903) 663-7393

6901 Medical Pkwy
Waco, TX 76712
Phone (254) 751-4000

7125 Sanger Rd
Ste A
Woodway, TX 76712
Phone (713) 797-0180

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376870400000",
    "number": "1558564641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4777 US HIGHWAY 259",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756057668",
            "telephone_number": "903-663-7393",
            "fax_number": "903-663-7394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6901 MEDICAL PKWY",
            "address_2": "RADIOLOGY DEPARTMENT",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127910",
            "telephone_number": "254-751-4299",
            "fax_number": "903-663-7394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JEFFERY",
        "middle_name": "RANDALL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2013-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "P2932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "302494501",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.