Bruce Allen White, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C5459 Issued in AR

Practice address

1002 Schneider Dr
Suite 104
Malvern, AR 72104-4816

Phone

(501) 337-9066

Fax

(501) 332-5265

NPI assigned

Feb 27, 2006

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 7

Medicare fee-for-service enrollment

Enrolled in AR

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Baptist Medcare, Inc

  • Emergency Medicine Physician
  • Little Rock, AR
  • NPI 1699868323
  Medicare reassignment NPD

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1881660058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11001 EXECUTIVE CENTER DR",
            "address_2": "SUITE 200",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722114316",
            "telephone_number": "501-812-7587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 SCHNEIDER DR",
            "address_2": "SUITE 104",
            "city": "MALVERN",
            "state": "AR",
            "postal_code": "721044816",
            "telephone_number": "501-337-9066",
            "fax_number": "501-332-5265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "BRUCE",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "C5459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4352987",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "FP99688",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NOVASYS",
            "identifier": "P00050",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102652001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "7967507",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "12697000000",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "480568",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor C. Watt, PHARM.D.
• We Speak Therapy LLC
• Sheryl Lynn Welch
• Tracie Wells, LPC
• Dillon R Wester
• Fawnda White, M.S., CCC-SLP
• Phillip White Jr., RECOVERY ASSISTANT
• Amy Elizabeth Whitworth, OTR
• Curtis Wiggins
• Iysha Wiggins, RECOVERY ASSISTANT

• Family Medicine Physician in Malvern, AR
• Providers in Malvern, AR by specialty
• Family Medicine Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.