Individual provider Active NPI

Adam J White, PA

  • Medical Physician Assistant
  • Joplin, MO
National Provider Identifier
1972607315
Registry record updated Sep 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
2005014703 Issued in MO
Practice address
2817 McClelland Blvd Ste 252
Joplin, MO 64804-1647
Phone
(417) 206-3103
Fax
(417) 206-3102
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 2005014703 MO Primary

Addresses

Primary practice location

2817 McClelland Blvd Ste 252
Joplin, MO 64804-1647

Mailing address

2817 McClelland Blvd Ste 252
Joplin, MO 64804-1647
Phone (417) 206-3103

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051005001069 MO Practitioner - Physician Assistant 9234154527 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, shared by 26 NPIs, 1,121 clinicians

Practice addresses (Care Compare)

1235 E Cherokee St
Springfield, MO 65804-2203

1605 Martin Springs Dr
Rolla, MO 65401-2980

2115 S Fremont Ave
Springfield, MO 65804-2232

2115 S Fremont Ave
3050 MC Infectious Disease Whiteside
Springfield, MO 65804-2236
Phone (417) 820-3905

Hospital & facility affiliations

  • Mercy Hospital Springfield Hospital, Springfield, MO, CCN 260065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2005014703MOMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities CurrentSince Nov 22, 2011 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Nov 22, 2011 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Nov 22, 2011 Accepting new patients
Juno Group LLC Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

94 Main St
Cassville, MO 65625
Phone (417) 782-7722

1020 McIntosh Cir
Ste 201
Joplin, MO 64804
Phone (417) 347-8585

100 Mercy Way
Joplin, MO 64804
Phone (417) 556-2300

3126 S Jackson Ave
Joplin, MO 64804
Phone (417) 782-1600

3050 E River Bluff Blvd
Ozark, MO 65721
Phone (417) 820-5610

1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

2115 S Fremont Ave
Ste 4300
Springfield, MO 65804
Phone (417) 829-3911

3045 S National Ave
Ste 110
Springfield, MO 65804
Phone (417) 820-5610

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

Interoperability endpoints

  • Direct secure messaging: awhite200109@directc.mercy.net

Organizations & group practices 5

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 9

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252368000000",
    "number": "1972607315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 MCCLELLAND BLVD STE 252",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041647",
            "telephone_number": "417-206-3103",
            "fax_number": "417-206-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 MCCLELLAND BLVD STE 252",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648041647",
            "telephone_number": "417-206-3103",
            "fax_number": "417-206-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "ADAM",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2009-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MO",
            "license": "2005014703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joplin, MO

Sources for this page

Verify at the official NPI Registry.