Individual provider Active NPI

Allison Randle White, MD

  • Nephrology Physician
  • Greenwood, MS
National Provider Identifier
1760559751
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
05863 Issued in MS
Practice address
609 Tallahatchie St
Greenwood, MS 38930-2005
Phone
(662) 453-5208
Fax
(662) 453-4546
NPI assigned
Nov 29, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 05863 MS Primary

Addresses

Primary practice location

609 Tallahatchie St
Greenwood, MS 38930-2005

Mailing address

609 Tallahatchie St
Greenwood, MS 38930-2005
Phone (662) 453-5208

Other identifiers 1

IdentifierTypeStateIssuer
00011930MedicaidMS

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20110926000868 MS Practitioner - Nephrology 8022056654 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of Mississippi School of Medicine, 1969
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delta Hills Nephrology AssociatesGroup PAC ID 0941248579, 3 clinicians
Delta Hills Nephrology Clinics PLLCGroup PAC ID 4486098555, 4 clinicians

Practice addresses (Care Compare)

609 Tallahatchie St
Greenwood, MS 38930-2005
Phone (601) 453-5208

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05863MSMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Hills Nephrology Clinics PLLC Nephrology CurrentSince Mar 1, 2024 Accepting new patients
Delta Hills Nephrology Associates Nephrology CurrentSince Oct 22, 1997 Accepting new patients
Isd Renal Inc PastSince Jul 1, 2013 Accepting new patients
Greenwood Leflore Hospital Past Accepting new patients

Locations

609 Tallahatchie St
Greenwood, MS 38930
Phone (601) 453-5208

110 E Baker St
Indianola, MS 38751
Phone (662) 887-5155

Interoperability endpoints

  • Direct secure messaging: allison.white.1@29589.direct.athenahealth.com
  • Direct secure messaging: white_randle_md@yourcarecommunity.org

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1760559751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 TALLAHATCHIE ST",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389302005",
            "telephone_number": "662-453-5208",
            "fax_number": "662-453-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 TALLAHATCHIE ST",
            "city": "GREENWOOD",
            "state": "MS",
            "postal_code": "389302005",
            "telephone_number": "662-453-5208",
            "fax_number": "662-453-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "ALLISON",
        "middle_name": "RANDLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MS",
            "license": "05863",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00011930",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, MS

Sources for this page

Verify at the official NPI Registry.