Charlean Violet White, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2162T Issued in OR

Practice address

9605 Grand Ronde Rd
Grand Ronde, OR 97347-9712

Phone

(503) 879-2236

Fax

(503) 879-5089

NPI assigned

Feb 15, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Charlean Violet Spotts Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Confederated Tribes of Grand Ronde Community of Oregon Dba GR Health &

  • Community Health Clinic/Center
  • Grand Ronde, OR
  • NPI 1104164359
  NPD (past)

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689717993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 338",
            "city": "GRAND RONDE",
            "state": "OR",
            "postal_code": "973470338",
            "telephone_number": "503-879-2236",
            "fax_number": "503-879-5089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9605 GRAND RONDE RD",
            "city": "GRAND RONDE",
            "state": "OR",
            "postal_code": "973479712",
            "telephone_number": "503-879-2236",
            "fax_number": "503-879-5089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "CHARLEAN",
        "middle_name": "VIOLET",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OR",
            "license": "2162T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHARLEAN",
            "last_name": "SPOTTS",
            "middle_name": "VIOLET",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Annette N Sampson
• Karan Elaine Scharf, CDCIII
• Wendy Monette Schmolzi, APRN, FNP-C
• Joseph Ulestad
• E. Eric Webster, DDS
• Brianna Wing, NP, RN
• Natasha Rae Worden, PEER SUPPORT
• Lincoln Wright, PHARMD
• Susan M Wright, FNP

• Optometrist in Grand Ronde, OR
• Providers in Grand Ronde, OR by specialty
• Optometrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.