Individual provider Active NPI

Jacqueline Ann White, DPM

  • Podiatrist
  • Orange, CA
National Provider Identifier
1992880025
Registry record updated Jun 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
E3447 Issued in CA
Practice address
2617 E Chapman Ave
Suite 303
Orange, CA 92869-3226
Phone
(714) 639-7993
Fax
(714) 639-0729
NPI assigned
Oct 26, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E3447 CA Primary
Foot & Ankle Surgery Podiatrist 213ES0103X E3447 CA

Addresses

Primary practice location

2617 E Chapman Ave
Suite 303
Orange, CA 92869-3226

Mailing address

2617 E Chapman Ave
Suite 303
Orange, CA 92869-3226
Phone (714) 639-7993

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090630000126 CA Practitioner - Podiatry 6002967213 Practice locations: Orange, CA

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E3447CAMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Chapman Medical Center Inc Past Accepting new patients
South Coast Global Medical Center, Inc 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433203200000",
    "number": "1992880025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 E CHAPMAN AVE",
            "address_2": "SUITE 303",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928693226",
            "telephone_number": "714-639-7993",
            "fax_number": "714-639-0729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2617 E CHAPMAN AVE",
            "address_2": "SUITE 303",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928693226",
            "telephone_number": "714-639-7993",
            "fax_number": "714-639-0729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JACQUELINE",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2015-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CA",
            "license": "E3447",
            "primary": true
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E3447",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange, CA

Sources for this page

Verify at the official NPI Registry.