Gordon Ellis White II, M.D.

Primary specialty

Military Health Care ProviderTaxonomy code 171000000X

License

025398 Issued in LA

Practice address

1900 E Main St
Danville, IL 61832-5100

Phone

(318) 801-4070

Fax

(318) 554-4807

NPI assigned

Oct 24, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Emergency Medicine

Education

University of Texas Medical Branch at Galveston, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Country Clinic LLCGroup PAC ID 4082936372, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Country Clinic, LLC

  • Family Medicine Physician
  • Simmesport, LA
  • NPI 1609825892
  Medicare reassignment Care Compare group NPD
• Cenla Occupational Medicine Services

  • Family Nurse Practitioner
  • Pineville, LA
  • NPI 1427399195
  Medicare reassignment NPD
• West Carroll Health Systems LLC

  • General Acute Care Hospital
  • Oak Grove, LA
  • NPI 1386700888
  Medicare reassignment NPD
• West Carroll Health Systems LLC

  • General Acute Care Hospital
  • Oak Grove, LA
  • NPI 1306843826
  NPD
• Crossroads Medical Consultants LLC

  • Internal Medicine Physician
  • Colfax, LA
  • NPI 1710162128
  NPD (past)
• Turn-Row Emergency Physicians LLC

  • Emergency Medicine Physician
  • Winnsboro, LA
  • NPI 1194903146
  NPD (past)

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623110400000",
    "number": "1639169485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 E MAIN ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618325100",
            "telephone_number": "318-801-4070",
            "fax_number": "318-554-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 E MAIN ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618325100",
            "telephone_number": "318-801-4070",
            "fax_number": "318-554-4807"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 4th St",
            "address_2": "Medical Plaza, Ste. 2E",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "LA",
            "postal_code": "713018421",
            "country_code": "US",
            "telephone_number": "318-443-9400",
            "fax_number": "318-442-9406",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "GORDON",
        "middle_name": "ELLIS",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2021-06-08",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "025398",
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "LA",
            "license": "025398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1423688",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jolene F Watson, LCSW
• Kaylee Nicole Wear
• Kylie Jo Weaver
• Hannah Wellburn
• Lindsay Rae Wheeler, RN
• Whitestar Companies, LLC
• Amy Wiedmann, LCSW
• Sharon Wilkins, RN
• David Phillips Williams, PHD
• Linda Foy Williams, PH.D.

• Military Health Care Provider in Danville, IL
• Providers in Danville, IL by specialty
• Military Health Care Provider in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2021; 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.