Individual provider Active NPI

Nathan James White, PH.D.

  • Counseling Psychologist
  • Bradenton, FL
National Provider Identifier
1700123536
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
PY 8659 Issued in FL
Practice address
6050 34TH St W Apt 121
Bradenton, FL 34210-3602
Phone
(941) 315-6895
NPI assigned
Jan 14, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling Psychologist 103TC1900X PY 8659 FL Primary

Addresses

Primary practice location

6050 34TH St W Apt 121
Bradenton, FL 34210-3602

Mailing address

PO Box 2062
Sarasota, FL 34230-2062
Phone (480) 323-9742

Other practice location 1

46 Peppermint Ln
Willingboro, NJ 08046-2716
Phone (480) 323-9742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, NJ, TX3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20130821000165 FL Practitioner - Clinical Psychologist 6002059102 Reassigns benefits to 1 organization
I20230707001196 NJ Practitioner - Clinical Psychologist 6002059102 Reassigns benefits to 1 organization
I20230727003449 TX Practitioner - Clinical Psychologist 6002059102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1201 6TH Ave W
Suite 100
Bradenton, FL 34205-7413
Phone (480) 323-9742

2240 Becton Way
Apt 4202
Fort Worth, TX 76177-3067
Phone (480) 323-9742

46 Peppermint LN
Willingboro, NJ 08046-2716
Phone (480) 323-9742

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PY 8659FLMDCounseling Psychologist
39623TXMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Smart Living Coaching Services LLC Counseling CurrentSince Aug 31, 2017 Accepting new patients

Locations

1201 6th Ave W
Ste 100
Bradenton, FL 34205
Phone (480) 323-9742

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1358121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1700123536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2062",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342302062",
            "telephone_number": "480-323-9742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6050 34TH ST W APT 121",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342103602",
            "telephone_number": "941-315-6895"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46 Peppermint Ln",
            "address_purpose": "LOCATION",
            "city": "Willingboro",
            "state": "NJ",
            "postal_code": "080462716",
            "country_code": "US",
            "telephone_number": "480-323-9742",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "NATHAN",
        "middle_name": "JAMES",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-01-14",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "FL",
            "license": "PY 8659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.