Jewel Johnny White, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD 16405 Issued in TN

Practice address

105 W Stone Dr
Ste 1F
Kingsport, TN 37660-3365

Phone

(423) 857-2793

Fax

(423) 578-8025

NPI assigned

Jun 1, 2005

Last updated

May 20, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• East Tennessee Hematology/Oncology Assoc P.C.

  • Oncology Clinic/Center
  • Johnson City, TN
  • NPI 1356446298
  NPD (past)
• Galen Medical Group, PC

  • Internal Medicine Physician
  • Hixson, TN
  • NPI 1346250057
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1400544000000",
    "number": "1871595058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "37662",
            "telephone_number": "423-857-2793",
            "fax_number": "423-578-8025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W STONE DR",
            "address_2": "STE 1F",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376603365",
            "telephone_number": "423-857-2793",
            "fax_number": "423-578-8025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JEWEL",
        "middle_name": "JOHNNY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2014-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD 16405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3025660",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5850002",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Shanks West, PT
• Larry H. Westerfield, M.D.
• Dennis Westmoreland, M.D.
• Wexford Operating Group LLC (The Wexford House)
• Elicia Nichole White, PHARMD
• Judith White, MD
• Misty White
• Morgan White, PHARM D
• Sandra J White, CRNA
• Sean P White, MD

• Internal Medicine Physician in Kingsport, TN
• Providers in Kingsport, TN by specialty
• Internal Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.