Individual provider Active NPI

David Matthew White, CRNA

  • Certified Registered Nurse Anesthetist
  • Pryor, OK
National Provider Identifier
1922338425
Registry record updated Jan 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
82301 Issued in OK
Practice address
111 N Bailey St
Pryor, OK 74361-4201
Phone
(918) 825-1600
Fax
(918) 824-6316
NPI assigned
Jan 5, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 82301 OK Primary

Addresses

Primary practice location

111 N Bailey St
Pryor, OK 74361-4201

Mailing address

111 N Bailey St
Pryor, OK 74361-4201
Phone (918) 825-1600

Other identifiers 1

IdentifierTypeStateIssuer
82301OtherOKSTATE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100319000415 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 2769517440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergenchealth PLLCGroup PAC ID 1355606641, 1,037 clinicians

Practice addresses (Care Compare)

111 N Bailey St
HC Hosp Pryor
Pryor, OK 74361-4201
Phone (918) 825-1600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Emergenchealth PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2019 Accepting new patients
Mayes County Hma, LLC Past Accepting new patients

Locations

10512 N 110th East Ave
Owasso, OK 74055
Phone (918) 272-1172

111 N Bailey St
Pryor, OK 74361
Phone (918) 824-7791

1120 S Utica Ave
Tulsa, OK 74104
Phone (918) 579-6090

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1262649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262649600000",
    "number": "1922338425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N BAILEY ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743614201",
            "telephone_number": "918-825-1600",
            "fax_number": "918-824-6316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N BAILEY ST",
            "city": "PRYOR",
            "state": "OK",
            "postal_code": "743614201",
            "telephone_number": "918-825-1600",
            "fax_number": "918-824-6316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "DAVID",
        "middle_name": "MATTHEW",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-05",
        "last_updated": "2010-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "82301",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "82301",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pryor, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.