Mark Douglas White, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101264388 Issued in VA

Practice address

650 Peter Jefferson Pkwy Ste 290
Charlottesville, VA 22911-8848

Phone

(434) 297-7140

Fax

(434) 297-7235

NPI assigned

Jun 14, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Karen Hultman Inc

  • Family Medicine Physician
  • Fayetteville, WV
  • NPI 1972594844
  NPD (past)

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642464000000",
    "number": "1992748180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5495 MAPLE LANE",
            "city": "FAYETTEVILLE",
            "state": "WV",
            "postal_code": "258409589",
            "telephone_number": "304-574-1888",
            "fax_number": "304-574-1891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 PETER JEFFERSON PKWY STE 290",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229118848",
            "telephone_number": "434-297-7140",
            "fax_number": "434-297-7235"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5495 Maple Lane",
            "address_2": "Maple Lane",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "WV",
            "postal_code": "258409589",
            "country_code": "US",
            "telephone_number": "304-574-1888",
            "fax_number": "304-574-1891",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "MARK",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "14161",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101264388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0057307000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Jane White, M.D.
• H. George White Jr., M.D.
• James L. White, MD
• Kenneth Ray White, PHD, A/G ACNP-BC
• Leela White, LPC
• Sheila White
• Shelby C. White, M.D.
• Tiffany Kristen White, PHARMD
• Richard Whitehill, M.D.
• Julia D Whiting, MD

• Family Medicine Physician in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.