Active NPI
Nathaniel Ebbets White, MD
- Pediatric Emergency Medicine (Pediatrics) Physician
- Providence, RI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Emergency Medicine (Pediatrics) Physician
- License
- MD20685
- Practice address
- 593 Eddy St.
Claverick 2
Providence, RI 02903 - Phone
- (401) 444-4000
- NPI assigned
- Mar 20, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Emergency Medicine (Pediatrics) Physician | 2080P0204X | 77195 | WI | |
| Pediatric Emergency Medicine (Pediatrics) Physician | 2080P0204X | MD20685 | RI | Primary |
Addresses
Primary practice location
593 Eddy St.
Claverick 2
Providence, RI 02903
Mailing address
110 Elm St
Providence, RI 02903-4626
Phone (401) 444-4000
Other practice location 1
9000 W Wisconsin Ave
Milwaukee, WI 53226-4874
Phone (414) 266-2625
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821558669 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI, RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- University of Vermont College of Medicine, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
55 Claverick St
FL 2
Providence, RI 02903-4144
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 77195 | WI | MD | Pediatric Emergency Medicine (Pediatrics) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifespan Physician Group Inc | Current | Accepting new patients | |
| The Medical College of Wisconsin, Inc. | Current | Accepting new patients | |
| Brown Emergency Medicine | Pediatric Emergency Medicine | Current | Accepting new patients |
| Lifespan Physician Group, Inc. | Pediatric Emergency Medicine | Current | Accepting new patients |
Locations
55 Claverick St
Fl 2
Providence, RI 02903
110 Elm St
Providence, RI 02903
Phone (401) 443-4992
593 Eddy St
#2
Providence, RI 02903
Phone (401) 519-1604
593 Eddy St
Providence, RI 02903
9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625
8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100
Organizations & group practices 5
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.
-
- Emergency Medicine Physician
- Providence, RI
- NPI 1962455022
Pediatric Emergency Medicine
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
-
- General Practice Physician
- Providence, RI
- NPI 1407116643
-
- Dermatology Physician
- Providence, RI
- NPI 1578424602
-
- Emergency Medicine Physician
- Providence, RI
- NPI 1568325678
Pediatric Emergency Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553040000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752624000000",
"number": "1821558669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 ELM ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029034626",
"telephone_number": "401-444-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "593 EDDY ST.",
"address_2": "CLAVERICK 2",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "02903",
"telephone_number": "401-444-4000"
}
],
"practiceLocations": [
{
"address_1": "9000 W Wisconsin Ave",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532264874",
"country_code": "US",
"telephone_number": "414-266-2625",
"fax_number": "414-266-2635",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WHITE",
"first_name": "NATHANIEL",
"middle_name": "EBBETS",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-20",
"last_updated": "2025-07-16",
"certification_date": "2025-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0204X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Emergency Medicine",
"state": "WI",
"license": "77195",
"primary": false
},
{
"code": "2080P0204X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Emergency Medicine",
"state": "RI",
"license": "MD20685",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1821558669",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.