NPIMap

Individual provider Active NPI

Kenneth Kyle White, M.D.

  • Diagnostic Radiology Physician
  • Lubbock, TX
National Provider Identifier
1649276072
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
L5953 Issued in TX
Practice address
4005 24TH St
Lubbock, TX 79410-1835
Phone
(806) 792-2767
Fax
(888) 861-8858
NPI assigned
Jun 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X L5953 TX Primary

Addresses

Primary practice location

4005 24TH St
Lubbock, TX 79410-1835

Mailing address

4005 24TH St
Lubbock, TX 79410-1835
Phone (806) 792-2767

Other identifiers 5

IdentifierTypeStateIssuer
139559100OtherTXFIRSTCARE
155904905MedicaidTX
8G1355OtherTXBLUE CROSS
P00152700OtherRAILROAD MEDICARE
92382321MedicaidNM

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
I20040421001060 TX Practitioner - Diagnostic Radiology 5597751073 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Medical Branch at Galveston, 1999
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

815 Pennsylvania Ave
Fort Worth, TX 76104-2224
Phone (817) 321-0470

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L5953TXMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Radiology Associates of North Texas CurrentSince Jan 1, 2022 Accepting new patients
Health Imaging Partners, LLC Diagnostic Radiology CurrentSince Dec 11, 2023 Accepting new patients
Health Imaging Partners, LLC Diagnostic Radiology CurrentSince Dec 11, 2023 Accepting new patients
Health Imaging Partners, LLC Diagnostic Radiology CurrentSince Dec 11, 2023 Accepting new patients
Health Imaging Partners LLC Diagnostic Radiology CurrentSince Dec 11, 2023 Accepting new patients
Health Imaging Partners LLC Diagnostic Radiology CurrentSince Mar 12, 2026 Accepting new patients
Health Imaging Partners, LLC Diagnostic Radiology CurrentSince Dec 11, 2023 Accepting new patients
Health Imaging Partners, LLC CurrentSince Dec 20, 2024 Accepting new patients
Health Imaging Partners, LLC Diagnostic Radiology CurrentSince Dec 11, 2023 Accepting new patients
Health Imaging Partners, LLC Diagnostic Radiology CurrentSince Nov 27, 2023 Accepting new patients
Health Imaging Partners, LLC Diagnostic Radiology CurrentSince Dec 4, 2023 Accepting new patients
Health Imaging Partners, LLC Diagnostic Radiology CurrentSince Dec 11, 2023 Accepting new patients
Health Imaging Partners, LLC Diagnostic Radiology CurrentSince Dec 11, 2023 Accepting new patients

Locations

17980 Dallas Pkwy
Ste 200
Dallas, TX 75287
Phone (972) 248-1303

815 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 321-0300

816 W Cannon St
Ft Worth, TX 76104
Phone (817) 321-0312

Organizations & group practices 15

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.

View all 15

Hospital & facility affiliations 5

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": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1649276072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 24TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101835",
            "telephone_number": "806-792-2767",
            "fax_number": "806-791-6709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 24TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101835",
            "telephone_number": "806-792-2767",
            "fax_number": "888-861-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KENNETH",
        "middle_name": "KYLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "L5953",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE",
            "identifier": "139559100",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155904905",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "8G1355",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00152700",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "92382321",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.