Active NPI
Larry Edward White, D.C.
- Chiropractor
- Brockton, MA
National Provider Identifier
1578627154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 533
- Practice address
- 787 Pearl St
Brockton, MA 02301-4425 - Phone
- (508) 583-5660
- Fax
- (508) 583-1800
- NPI assigned
- Dec 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 533 | MA | Primary |
Addresses
Primary practice location
787 Pearl St
Brockton, MA 02301-4425
Mailing address
787 Pearl St.
Brockton, MA 02301
Phone (508) 583-5660
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Y39454 | Other | MA | BLUE CROSS GROUP |
| WHY35353 | Other | MA | BLUE CROSS |
| 1602985 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060424000593 | MA | Practitioner - Chiropractic | 2365452174 | Practice locations: Brockton, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
787 Pearl St
Brockton, MA 02301-4425
Phone (508) 583-5660
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 533 | MA | MD | Acupuncturist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166572800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380240000000",
"number": "1578627154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "787 PEARL ST.",
"city": "BROCKTON",
"state": "MA",
"postal_code": "02301",
"telephone_number": "508-583-5660",
"fax_number": "508-583-1800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "787 PEARL ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023014425",
"telephone_number": "508-583-5660",
"fax_number": "508-583-1800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "LARRY",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-20",
"last_updated": "2013-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MA",
"license": "533",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS GROUP",
"identifier": "Y39454",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "WHY35353",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1602985",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.