Individual provider Active NPI

Richard K White, PH.D

  • Psychologist
  • Gorham, ME
National Provider Identifier
1659350098
Registry record updated Dec 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
00647 Issued in ME
Practice address
510 Main St
Gorham, ME 04038-1339
Phone
(207) 839-6061
NPI assigned
Jan 13, 2006
Last updated
Dec 28, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 00647 ME Primary

Addresses

Primary practice location

510 Main St
Gorham, ME 04038-1339

Mailing address

26 Edes Rd
Cumberland, ME 04021-4101
Phone (207) 829-6912

Other identifiers 1

IdentifierTypeStateIssuer
216390000MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050622000190 ME Practitioner - Clinical Psychologist 5294770111 Practice locations: Cumberland Center, ME

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

26 Edes Rd
Cumberland Center, ME 04021-4101
Phone (207) 839-6061

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00647MEMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Villi P Enders PA Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356652800000",
    "number": "1659350098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 EDES RD",
            "city": "CUMBERLAND",
            "state": "ME",
            "postal_code": "040214101",
            "telephone_number": "207-829-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 MAIN ST",
            "city": "GORHAM",
            "state": "ME",
            "postal_code": "040381339",
            "telephone_number": "207-839-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "RICHARD",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2012-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ME",
            "license": "00647",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "216390000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gorham, ME

Sources for this page

Verify at the official NPI Registry.