IDA V WHITE PA
NPI 1154882538
Physician Assistant - Medical in Providence, RI

Q: What is Ida White's NPI number?

The NPI number for Ida White is 1154882538. It was assigned to this individual provider in the NPPES registry on March 27, 2019.

Q: What is Ida White's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Ida White was last updated on June 21, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since March 27, 2019PECOS Enrolled

164 SUMMIT AVE, PROVIDENCE, RI 02906(401) 793-4102(401) 793-4049 Get Directions Write a Review

NPPES record last updated: June 21, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: May 10, 2022, Jul 9, 2020 (2 updates tracked since 2020).

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About Ida V White Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IDA V WHITE PA (NPI 1154882538) is an individual medical provider in Providence, Rhode Island, licensed in Rhode Island (PA01458) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154882538

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameIDA V WHITECredential: PA

Location Address164 SUMMIT AVEProvidence, RI 02906

Mailing Address117 Ellenfield St Ste 101Providence, RI 02905-4541

Phone(401) 793-4102

Fax(401) 793-4049

Sole ProprietorNo

Enumeration DateMarch 27, 2019

Last NPPES UpdateJune 21, 20222 updates tracked since enumeration

NPPES CertifiedJune 21, 2022

✔ NPI 1154882538 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in RI · PA01458

164 SUMMIT AVE, Providence, RI 02906

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ida V White Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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