Individual provider Active NPI

Krishna Ewan White, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Gainesville, FL
National Provider Identifier
1861933038
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1707 N Main St
Gainesville, FL 32609-3650
Phone
(352) 265-9522
NPI assigned
Mar 20, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1707 N Main St
Gainesville, FL 32609-3650

Mailing address

PO Box 100237
Gainesville, FL 32610-3001
Phone (352) 265-9522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210617000580 FL Practitioner - Family PracticePractitioner - Sports Medicine 5092088484 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Health & Sports Medicine LLC CurrentSince Aug 1, 2021 Accepting new patients

Locations

115 Bartram Oaks Walk
Ste 104
St Johns, FL 32259
Phone (904) 240-0442

201 Village Oaks Dr
St Johns, FL 32259
Phone (904) 240-0442

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8428/brand/1/csg/1/fhir/r4

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": "1489968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489968000000",
    "number": "1861933038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100237",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103001",
            "telephone_number": "352-265-9522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1707 N MAIN ST",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326093650",
            "telephone_number": "352-265-9522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KRISHNA",
        "middle_name": "EWAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-20",
        "last_updated": "2017-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.