MR. JOHNNY WHITE LCSW
NPI 1306149497
Social Worker - Clinical in South Holland, IL
About Mr. Johnny White Lcsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. JOHNNY WHITE LCSW (NPI 1306149497) is an individual clinical provider in South Holland, Illinois, licensed in Illinois (14900674) and active in the NPI registry since December 2010. He is enrolled in Medicare PECOS and is a graduate of Other (1993).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. Johnny White Lcsw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
5Medicare enrollment records show Johnny White reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
South Holland, IL 60473
- Reassigned Medicare billing, Illinois enrollment
- 27 clinicians in this Medicare group
Tinley Park, IL 60477
- Reassigned Medicare billing, Illinois enrollment
- 3 clinicians in this Medicare group
Orland Park, IL 60467
- Reassigned Medicare billing, Illinois enrollment
- 9 clinicians in this Medicare group
Durham, NC 27701
- Reassigned Medicare billing, Illinois enrollment
- 107 clinicians in this Medicare group
San Jose, CA 95119
- Reassigned Medicare billing, Illinois enrollment
- 106 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 60473 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Reported Quality Measures
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SOUTH HOLLAND, IL 60473
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Johnny White's NPI number?
The NPI number for Johnny White is 1306149497. It was assigned to this individual provider in the NPPES registry on December 10, 2010.
Where is Johnny White located?
Johnny White practices at 15663 Kimbark Ave, South Holland, IL 60473. The listed phone number is (630) 747-4498.
What is Johnny White's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Johnny White enrolled in Medicare?
Yes. Johnny White is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Johnny White's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Johnny White reassigns Medicare benefits to 5 organizations: Christian Community Health Center (South Holland, IL), Victory Mental Services LLC (Tinley Park, IL), Lifecore Rehab And Counseling Services Sc (Orland Park, IL), Mental Health Specialty Group PA (Durham, NC) and Sondermind PC (San Jose, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Johnny White's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Johnny White was last updated on December 10, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mr. Johnny White, LCSW · NPI 1306149497
Clinical provider in South Holland, Illinois. Individual provider, active in the CMS NPPES registry since December 10, 2010.
## Identity
- **NPI:** 1306149497 (Entity type: Individual)
- **Enumerated:** December 10, 2010
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **State license:** 14900674 (Illinois)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 15663 KIMBARK AVE, South Holland, IL 60473-1826
- **Phone:** (630) 747-4498
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): Christian Community Health Center (NPI 1912170457, South Holland, IL); Victory Mental Services LLC (NPI 1629870506, Tinley Park, IL); Lifecore Rehab And Counseling Services Sc (NPI 1679819734, Orland Park, IL); Mental Health Specialty Group PA (NPI 1801472634, Durham, NC); Sondermind PC (NPI 1003646977, San Jose, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 1993
## Record status
- **NPPES last updated:** December 10, 2010
- **Other identifiers:** Other 14900674 (IL)
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Source: [NPI Profile](https://npiprofile.com/npi/1306149497) · Data from the CMS NPPES public registry.