Individual provider Active NPI

Stephanie G White, RN

  • Psychiatric/Mental Health Nurse Practitioner
  • Spartanburg, SC
National Provider Identifier
1689924532
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
29933 Issued in SC
Practice address
250 Dewey Ave
Spartanburg, SC 29303-3009
Phone
(864) 585-0366
NPI assigned
Sep 18, 2012
Last updated
Mar 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 247227 NC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 29933 SC Primary

Addresses

Primary practice location

250 Dewey Ave
Spartanburg, SC 29303-3009

Mailing address

250 Dewey Ave
Spartanburg, SC 29303-3009

Other identifiers 1

IdentifierTypeStateIssuer
1760596480MedicaidSC

Other names 1

  • Stephanie N Gaetano Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251208001598 SC Practitioner - Nurse Practitioner 9436642402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

250 Dewey Ave
Spartanburg, SC 29303-3009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
247227NCMDRegistered Nurse
29933SCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Nov 3, 2025 Accepting new patients
South Carolina Dept of Mental Health Accounting Office Current Accepting new patients
South Carolina Dept of Mental Health Accounting Office CurrentSince Nov 3, 2025 Accepting new patients

Locations

2100 Charlie Hall Blvd
Charleston, SC 29414
Phone (843) 212-8968

125 E Robinson St
Gaffney, SC 29340
Phone (864) 487-2710

250 Dewey Ave
Spartanburg, SC 29303
Phone (864) 585-0366

Organizations & group practices 3

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": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1689924532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 DEWEY AVE",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 DEWEY AVE",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293033009",
            "telephone_number": "864-585-0366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "STEPHANIE",
        "middle_name": "G",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NC",
            "license": "247227",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "SC",
            "license": "29933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760596480",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "GAETANO",
            "middle_name": "N",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.