Individual provider Active NPI

Kayla Edna Marie White, PA-C

  • Physician Assistant
  • Denver, CO
National Provider Identifier
1821792086
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4700 E Iliff Ave
Denver, CO 80222-6025
Phone
(303) 335-0062
NPI assigned
Mar 29, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X CO Primary

Addresses

Primary practice location

4700 E Iliff Ave
Denver, CO 80222-6025

Mailing address

4700 E Iliff Ave
Denver, CO 80222-6025
Phone (302) 397-7182

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240807002256 CO Practitioner - Physician Assistant 4385181486 Reassigns benefits to 1 organization
I20250327002459 PA Practitioner - Physician Assistant 4385181486 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

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": "1680048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1821792086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 E ILIFF AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802226025",
            "telephone_number": "302-397-7182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 E ILIFF AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802226025",
            "telephone_number": "303-335-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KAYLA",
        "middle_name": "EDNA MARIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.