Active NPI
Eddie Dean Tyler White
- Physician Assistant
- Winston Salem, NC
National Provider Identifier
1649133208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-06351
- Practice address
- Medical Center Blvd
Winston Salem, NC 27157-0001 - Phone
- (336) 716-4626
- Fax
- (336) 716-5438
- NPI assigned
- Dec 9, 2025
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-06351 | NC | Primary |
Addresses
Primary practice location
Medical Center Blvd
Winston Salem, NC 27157-0001
Mailing address
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-4626
Other practice location 1
100 Campus Dr
Elon, NC 27244-9423
Phone (336) 278-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Wake Forest University Health Sciences
Practice addresses (Care Compare)
Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-06351 | NC | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1765238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780790400000",
"number": "1649133208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "MEDICAL CENTER BLVD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271570001",
"telephone_number": "336-716-4626",
"fax_number": "336-716-5438"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "MEDICAL CENTER BLVD",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271570001",
"telephone_number": "336-716-4626",
"fax_number": "336-716-5438"
}
],
"practiceLocations": [
{
"address_1": "100 Campus Dr",
"address_purpose": "LOCATION",
"city": "Elon",
"state": "NC",
"postal_code": "272449423",
"country_code": "US",
"telephone_number": "336-278-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WHITE",
"first_name": "EDDIE",
"middle_name": "DEAN TYLER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-12-09",
"last_updated": "2026-06-07",
"certification_date": "2026-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-06351",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winston Salem, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2026; 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.