Individual provider Active NPI

Evaciaira White, AGPCNP

  • Nurse Practitioner
  • Jackson, MI
National Provider Identifier
1831874569
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
4704331165 Issued in MI
Practice address
1201 E Michigan Ave
Jackson, MI 49201-1852
Phone
(517) 205-4841
NPI assigned
Jun 20, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 4704331165 MI
Nurse Practitioner 363L00000X 4704331165 MI Primary

Addresses

Primary practice location

1201 E Michigan Ave
Jackson, MI 49201-1852

Mailing address

1 Ford PL Ste 3a
Detroit, MI 48202-3450
Phone (313) 874-4806

Other practice location 1

2800 W Grand Blvd
Detroit, MI 48202-2610
Phone (888) 777-4167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230731000423 MI Practitioner - Nurse Practitioner 0446611065 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Henry Ford Health SystemGroup PAC ID 0547178311, 2,550 clinicians

Practice addresses (Care Compare)

1201 E Michigan Ave
200 Henry Ford Allegiance Pain Management C
Jackson, MI 49201-1855
Phone (517) 205-4841

2799 W Grand Blvd
Detroit, MI 48202-2608
Phone (313) 916-2600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Ford Health System CurrentSince Nov 1, 2025 Accepting new patients
W.a. Foote Memorial Hospital, Inc Nurse Practitioner CurrentSince Jul 10, 2023 Accepting new patients
Henry Ford Health System Nurse Practitioner CurrentSince Nov 1, 2025 Accepting new patients
Wa Foote Memorial Hospital, Inc Nurse Practitioner Current Accepting new patients
W.a. Foote Memorial Hospital, Inc CurrentSince Jul 10, 2023 Accepting new patients
Wa Foote Memorial Hospital, Inc Past Accepting new patients

Locations

2800 W Grand Blvd
Detroit, MI 48202
Phone (313) 230-1078

2799 W Grand Blvd
Detroit, MI 48202
Phone (313) 876-2062

1 Ford Pl
Ste 3A
Detroit, MI 48202
Phone (313) 874-2892

1201 E Michigan Ave
Ste 200
Jackson, MI 49201
Phone (517) 204-4841

813 W Michigan Ave
Jackson, MI 49202
Phone (517) 205-1000

1201 E Michigan Ave
Jackson, MI 49201
Phone (517) 205-1431

7845 Spring Arbor Rd
Spring Arbor, MI 49283
Phone (517) 205-2580

Interoperability endpoints

  • Direct secure messaging: ewhite866507@direct.hfhs.org

Organizations & group practices 6

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.

Hospital & facility affiliations 2

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": "1687219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1831874569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 E MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011852",
            "telephone_number": "517-205-4841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 W Grand Blvd",
            "address_purpose": "LOCATION",
            "city": "Detroit",
            "state": "MI",
            "postal_code": "482022610",
            "country_code": "US",
            "telephone_number": "888-777-4167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "EVACIAIRA",
        "name_prefix": "Ms.",
        "credential": "AGPCNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-20",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704331165",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704331165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

Verify at the official NPI Registry.