Individual provider Active NPI

Wayne Walter White, DC

  • Chiropractor
  • Ft Lauderdale, FL
National Provider Identifier
1891782769
Registry record updated Jul 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH0006397 Issued in FL
Practice address
200 SE 12TH St
Ft Lauderdale, FL 33316-1816
Phone
(954) 463-2404
Fax
(954) 463-2307
NPI assigned
Oct 5, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH0006397 FL Primary

Addresses

Primary practice location

200 SE 12TH St
Ft Lauderdale, FL 33316-1816

Mailing address

200 SE 12TH St
Ft Lauderdale, FL 33316-1816
Phone (954) 463-2404

Other identifiers 1

IdentifierTypeStateIssuer
380318000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101202000793 FL Practitioner - Chiropractic 0840486833 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

200 SE 12TH St
Fort Lauderdale, FL 33316-1816
Phone (954) 463-2404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Fort Lauderdale Chiropractic Center Chiropractor CurrentSince Jul 8, 2010 Accepting new patients

Locations

200 SE 12th St
Ft Lauderdale, FL 33316
Phone (305) 463-2404

Networks

  • Freedom Health HMO Network

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": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280188800000",
    "number": "1891782769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 SE 12TH ST",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161816",
            "telephone_number": "954-463-2404",
            "fax_number": "954-463-2307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SE 12TH ST",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161816",
            "telephone_number": "954-463-2404",
            "fax_number": "954-463-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "WAYNE",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2010-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH0006397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "380318000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ft Lauderdale, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2010; 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.