Richard A White, MD
Individual provider Active NPI Orthopaedic Surgery Physician · Mexico, MO
NPI 1770536856 · NPPES record last updated Jan 7, 2016
Key facts
- NPI
- 1770536856
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- License
- 2005000797 (MO)
- Practice address
- 515 E Promenade St
Mexico, MO 65265-2966 - Phone
- (573) 582-0157
- Fax
- (573) 581-4995
- NPI assigned
- May 18, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 20
Hospital & facility affiliations 15
Medicare Care Compare profile
- Specialty
- Sports Medicine
- Education
- University of Arkansas College of Medicine, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Cedar County Memorial Hospital
John Fitzgibbon Memorial Hospital Inc
Practice addresses (Care Compare)
1317 S State Hwy 32
CCMH Medical Mall Clinic
El Dorado Springs, MO 64744-2302
Phone (417) 876-3333
2305 S Hwy 65
Marshall, MO 65340-3702
Phone (660) 831-3553
Hospital & facility affiliations
- Fitzgibbon Hospital
- Cedar County Memorial Hospital
- Bothwell Regional Health Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Lower limb (leg) arthroscopy (minimally invasive joint repair) | 1-10 |
| Upper limb (arm) arthroscopy (minimally invasive joint repair) | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050422000015 | MO | Practitioner - Sports Medicine |
4981656048 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2005000797 | MO | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John Fitzgibbon Memorial Hospital, Inc. | Current | Accepting new patients | |
| Cedar County Memorial Hospital | Current | Accepting new patients | |
| John Fitzgibbon Memorial Hospital Inc | Current |
Accepting new patients | |
| Ozarks Medical Center | Past | Accepting new patients | |
| John Fitzgibbon Memorial Hospital, Inc. | Past | Accepting new patients | |
| Cedar County Memorial Hospital | Past | Accepting new patients |
Locations
1401 S Park St
El Dorado Springs, MO 64744
Phone (417) 876-2511
1317 S State Highway 32
El Dorado Springs, MO 64744
Phone (417) 876-3333
600 W Morrison St
Ste 5
Fayette, MO 65248
Phone (660) 248-2900
2305 S Highway 65
Marshall, MO 65340
Phone (660) 831-3730
2305 S Highway 65
Fl 2
Marshall, MO 65340
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 2005000797 | MO | Yes |
Addresses
Primary practice location
515 E Promenade St
Mexico, MO 65265-2966
Mailing address
PO Box 1027
Jefferson City, MO 65102-1027
Phone (573) 681-3767
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00239066 | Other | MO | RR MEDICARE |
| 207249301 | Medicaid | MO |
Other providers in Mexico, MO
- Kathleen M Weaver
- Webber Pharmacy, Inc
- Webber Pharmacy, Inc
- Sandra Weber
- Lyndsay Gail Wheeler
- Carl L Willingham
- Eric Daniel Witt
- Aaron Witte
- Brandy Lynn Worley
- Ziva Medical Audrain LLC
All providers in Mexico, MO · Orthopaedic Surgery Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.