Individual provider Active NPI

Charles White

  • Occupational Therapist
  • Palm Springs, CA
National Provider Identifier
1700216835
Registry record updated Jul 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT4500 Issued in CA
Practice address
552 S Paseo Dorotea
Suite 4
Palm Springs, CA 92264-1437
Phone
(760) 325-5950
NPI assigned
Nov 27, 2013
Last updated
Jul 10, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT4500 CA Primary

Addresses

Primary practice location

552 S Paseo Dorotea
Suite 4
Palm Springs, CA 92264-1437

Mailing address

552 S Paseo Dorotea
Suite 4
Palm Springs, CA 92264-1437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140128001007 CA Practitioner - Occupational Therapist in Private Practice 2466681234 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
All Star Physical TherapyGroup PAC ID 7719030949, 149 clinicians

Practice addresses (Care Compare)

69730 Hwy 111
Suite 100
Rancho Mirage, CA 92270-2873
Phone (760) 636-5207

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4500CAMDProfessional Counselor
OT4500CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MDRS Spine & Sport, Inc Occupational Therapist CurrentSince Feb 1, 2019 Accepting new patients
All Star Physical Therapy CurrentSince May 20, 2024 Accepting new patients
Elite Physical Therapy and Wellness, Inc. CurrentSince Mar 7, 2021 Accepting new patients
MDRS Spine & Sport, Inc Occupational Therapist CurrentSince Feb 1, 2019 Accepting new patients

Locations

16008 Kamana Rd
Ste 200
Apple Valley, CA 92307
Phone (760) 810-7767

1020 Tierra del Rey
Ste A1
Chula Vista, CA 91910
Phone (619) 585-7104

50225 Harrison St
Ste 103
Coachella, CA 92236
Phone (760) 698-8183

24630 Washington Ave
Ste 201
Murrieta, CA 92562
Phone (951) 200-3620

552 S Paseo Dorotea
Ste 4
Palm Springs, CA 92264
Phone (760) 325-5945

450 W Palmdale Blvd
Palmdale, CA 93551
Phone (661) 273-5333

1338 Main St
Ramona, CA 92065
Phone (760) 789-1400

35900 Bob Hope Dr
Ste 115
Rancho Mirage, CA 92270
Phone (760) 321-0739

69730 Highway 111
Ste 100
Rancho Mirage, CA 92270
Phone (760) 636-5207

29645 Rancho California Rd
Ste 234
Temecula, CA 92591
Phone (951) 506-3001

Organizations & group practices 4

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": "1385510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1700216835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "552 S PASEO DOROTEA",
            "address_2": "SUITE 4",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922641437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "552 S PASEO DOROTEA",
            "address_2": "SUITE 4",
            "city": "PALM SPRINGS",
            "state": "CA",
            "postal_code": "922641437",
            "telephone_number": "760-325-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-27",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "OT4500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.