Kimberly A White, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

ME62896 Issued in FL

Practice address

1600 SW Archer Rd
Gainesville, FL 32610-3003

Phone

(352) 294-5193

Fax

(352) 846-1455

NPI assigned

Jun 9, 2006

Sex

Female

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

Other names 1

• Kimberly A White Other name

Medicare fee-for-service enrollment

Enrolled in ND

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

Psychiatry

Education

University of South Florida College of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Southeast Human Service CenterGroup PAC ID 8527027556, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Southeast Behavioral Health Clinic

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fargo, ND
  • NPI 1932146941
  Medicare reassignment Care Compare group NPD
• Lake Region Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Devils Lake, ND
  • NPI 1669411930
  Medicare reassignment NPD
• North Central Behavioral Health Clinic

  • Clinic/Center
  • Minot, ND
  • NPI 1477592533
  Medicare reassignment NPD
• Northeast Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Grand Forks, ND
  • NPI 1366496341
  Medicare reassignment NPD
• Northwest Behavioral Health Clinic

  • Adult Mental Health Clinic/Center
  • Williston, ND
  • NPI 1770524613
  Medicare reassignment NPD
• South Central Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Jamestown, ND
  • NPI 1225075906
  Medicare reassignment NPD
• West Central Behavioral Health Clinic

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bismarck, ND
  • NPI 1649226713
  Medicare reassignment NPD
• Northeast Human Service Center

  • Emotionally Disturbed Childrens' Residential Treatment Facility
  • Grand Forks, ND
  • NPI 1891808978
  NPD
• Baycare Behavioral Health Centers, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • St Petersburg, FL
  • NPI 1306057187
  NPD (past)

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1689615619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 918025",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328918025",
            "telephone_number": "352-294-5193",
            "fax_number": "352-846-1455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-294-5193",
            "fax_number": "352-846-1455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2624 9th Ave S",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "581032350",
            "country_code": "US",
            "telephone_number": "701-298-4500",
            "fax_number": "701-298-4400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KIMBERLY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "ND",
            "license": "PT14824",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "FL",
            "license": "ME62896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376324200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "WHITE",
            "middle_name": "A",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jared Allen White
• Jeffrey David White, MD
• Karen Usher White, MSW
• Kayla White
• Keesha White
• Kimberly Noelle White, MSW
• Krishna Ewan White, M.D.
• Lakel Ariel White
• Lauria White
• Leah Ann White, APRN

• Child & Adolescent Psychiatry Physician in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Child & Adolescent Psychiatry Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.