Active NPI
David J White, CADC I
- Counselor
- Keizer, OR
National Provider Identifier
1972826220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 415-051-0000
- Practice address
- 3793 River Rd N
Keizer, OR 97303-4827 - Phone
- (503) 304-7002
- Fax
- (503) 304-7049
- NPI assigned
- Mar 1, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 415-051-0000 | OR | Primary |
| Counselor | 101Y00000X | 415-051-0130 | OR | |
| Counselor | 101Y00000X | 415-054-0005 | OR |
Addresses
Primary practice location
3793 River Rd N
Keizer, OR 97303-4827
Mailing address
3793 River Rd N
Keizer, OR 97303-4827
Phone (503) 304-7002
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 415-051-0000 | OR | MD | Counselor |
| 415-051-0130 | OR | MD | Counselor |
| 415-054-0005 | OR | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clear Paths Inc | 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.
-
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- Dallas, OR
- NPI 1184633141
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267401600000",
"number": "1972826220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3793 RIVER RD N",
"city": "KEIZER",
"state": "OR",
"postal_code": "973034827",
"telephone_number": "503-304-7002",
"fax_number": "503-304-7049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3793 RIVER RD N",
"city": "KEIZER",
"state": "OR",
"postal_code": "973034827",
"telephone_number": "503-304-7002",
"fax_number": "503-304-7049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "DAVID",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "CADC I",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-03-01",
"last_updated": "2010-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OR",
"license": "415-051-0000",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OR",
"license": "415-051-0130",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "OR",
"license": "415-054-0005",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Keizer, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.