Active NPI
Barry Whites, MD
- Pulmonary Disease Physician
- Jackson, MS
National Provider Identifier
1922003953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 06787
- Practice address
- 1151 N State St
Ste 617
Jackson, MS 39202-2407 - Phone
- (601) 352-5864
- Fax
- (601) 352-5867
- NPI assigned
- Jun 16, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 06787 | MS | Primary |
Addresses
Primary practice location
1151 N State St
Ste 617
Jackson, MS 39202-2407
Mailing address
1151 N State St
Ste 617
Jackson, MS 39202-2407
Phone (601) 352-5864
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00014870 | Medicaid | MS | |
| 290004751 | Other | RAILROAD MEDICARE | |
| 512 1 290009 | Other | MS | PTAM |
| 4830011 | Other | UNITED HEALTHCARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06787 | MS | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brandon Hma LLC | Past | Accepting new patients |
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.
-
- Psychiatric Hospital Unit
- Brandon, MS
- NPI 1427098391
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420588800000",
"number": "1922003953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1151 N STATE ST",
"address_2": "STE 617",
"city": "JACKSON",
"state": "MS",
"postal_code": "392022407",
"telephone_number": "601-352-5864",
"fax_number": "601-352-5867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1151 N STATE ST",
"address_2": "STE 617",
"city": "JACKSON",
"state": "MS",
"postal_code": "392022407",
"telephone_number": "601-352-5864",
"fax_number": "601-352-5867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITES",
"first_name": "BARRY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-16",
"last_updated": "2015-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "MS",
"license": "06787",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00014870",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "290004751",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAM",
"identifier": "512 1 290009",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "4830011",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.