Individual provider Active NPI

Stephen Spindler White, O.D.

  • Optometrist
  • Kendallville, IN
National Provider Identifier
1902916075
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18001405 Issued in IN
Practice address
2501 E North St
Kendallville, IN 46755-3231
Phone
(260) 343-0149
Fax
(260) 343-0283
NPI assigned
Aug 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18001405 IN Primary

Addresses

Primary practice location

2501 E North St
Kendallville, IN 46755-3231

Mailing address

430 E 280 N
Angola, IN 46703-9587
Phone (260) 343-0149

Other identifiers 1

IdentifierTypeStateIssuer
3944090001OtherINDMOPS #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060228000732 IN Practitioner - Optometry 3971519968

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902916075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 E 280 N",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467039587",
            "telephone_number": "260-343-0149",
            "fax_number": "260-343-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 E NORTH ST",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467553231",
            "telephone_number": "260-343-0149",
            "fax_number": "260-343-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "STEPHEN",
        "middle_name": "SPINDLER",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18001405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMOPS #",
            "identifier": "3944090001",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kendallville, IN

Sources for this page

Verify at the official NPI Registry.