Individual provider Active NPI

Frederick A White, PHD

  • Psychologist
  • Readfield, ME
National Provider Identifier
1962546911
Registry record updated Jan 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PS858 Issued in ME
Practice address
169 South Rd
Readfield, ME 04355-3340
Phone
(207) 622-6201
Fax
(888) 765-8406
NPI assigned
Feb 16, 2007
Last updated
Jan 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X PS858 ME Primary

Addresses

Primary practice location

169 South Rd
Readfield, ME 04355-3340

Mailing address

169 South Rd
Readfield, ME 04355-3340
Phone (207) 662-6201

Other identifiers 1

IdentifierTypeStateIssuer
018300OtherMEANTHEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050607001013 ME Practitioner - Clinical Psychologist 2062455314 Practice locations: Readfield, ME

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PS858MEMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Kennebec Valley Chiropractic Past Accepting new patients
Cotone Family Chiropractic LLC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579305600000",
    "number": "1962546911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "169 SOUTH RD",
            "city": "READFIELD",
            "state": "ME",
            "postal_code": "043553340",
            "telephone_number": "207-662-6201",
            "fax_number": "888-765-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 SOUTH RD",
            "city": "READFIELD",
            "state": "ME",
            "postal_code": "043553340",
            "telephone_number": "207-622-6201",
            "fax_number": "888-765-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "FREDERICK",
        "middle_name": "A",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2020-01-18",
        "certification_date": "2020-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "ME",
            "license": "PS858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "018300",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Readfield, ME

Sources for this page

Verify at the official NPI Registry.