Jay White, DC, CCSP, ATC

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

5701-12 Issued in WI

Practice address

N8302 US Highway 12
Elkhorn, WI 53121-2429

Phone

(603) 856-6030

NPI assigned

Jan 25, 2022

Last updated

Jan 25, 2022By 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

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Specialty

Chiropractic

Education

Western States College of Chiropractic, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Pro Sport and Spine PLLC

  • Sports Physician Chiropractor
  • Gig Harbor, WA
  • NPI 1841672433
  Medicare reassignment
• Body Renovation Physical Therapy SC

  • Physical Therapist
  • Grafton, WI
  • NPI 1871664243
  NPD (past)

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

{
    "created_epoch": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1891447447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N8302 US HIGHWAY 12",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531212429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N8302 US HIGHWAY 12",
            "city": "ELKHORN",
            "state": "WI",
            "postal_code": "531212429",
            "telephone_number": "603-856-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JAY",
        "credential": "DC, CCSP, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "WI",
            "license": "5701-12",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Weitkum, SAC-IT
• Karen Elizabeth West, LPN
• Debra K. Westby, APSW
• Rosemary Eve Weste, RN
• Brian Wexler, MSW, LPC, CADC-D
• Lauren Whitman
• Shawn Whitman
• Mindy Wilcox
• Marjorie Ann Willett, APNP
• Laura J Wimmer, RDH

• Sports Physician Chiropractor in Elkhorn, WI
• Providers in Elkhorn, WI by specialty
• Sports Physician Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.