Active NPI
Kevin Willson White
- Nurse's Aide
- Pullman, WA
National Provider Identifier
1851066401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- 367496
- Practice address
- 1440 NE Merman Dr
Pullman, WA 99163-5069 - Phone
- (406) 812-0551
- NPI assigned
- Aug 14, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 367496 | MT | Primary |
Addresses
Primary practice location
1440 NE Merman Dr
Pullman, WA 99163-5069
Mailing address
1440 NE Merman Dr
Pullman, WA 99163-5069
Phone (406) 812-0551
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4128555 | Other | MT | HEALTHY MONTANA KIDS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 367496 | MT | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1628899200000",
"number": "1851066401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1440 NE MERMAN DR",
"city": "PULLMAN",
"state": "WA",
"postal_code": "991635069",
"telephone_number": "406-812-0551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1440 NE MERMAN DR",
"city": "PULLMAN",
"state": "WA",
"postal_code": "991635069",
"telephone_number": "406-812-0551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "KEVIN",
"middle_name": "WILLSON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-08-14",
"last_updated": "2021-08-14",
"certification_date": "2021-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse's Aide",
"state": "MT",
"license": "367496",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHY MONTANA KIDS",
"identifier": "4128555",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pullman, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.