Active NPI
Casaundra White
- Behavior Technician
- Canton, GA
National Provider Identifier
1003451394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 19-98984
- Practice address
- 535 Riverstone Pkwy Ste 100
Canton, GA 30114-5328 - Phone
- (470) 531-0430
- Fax
- (470) 408-2550
- NPI assigned
- Nov 11, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | 19-98984 | GA | Primary |
Addresses
Primary practice location
535 Riverstone Pkwy Ste 100
Canton, GA 30114-5328
Mailing address
300 International Pkwy Ste 200
Lake Mary, FL 32746-5028
Phone (706) 980-4700
Other practice location 1
2121 Highway 140 NW
Adairsville, GA 30103-4809
Phone (706) 980-4700
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 |
|---|---|---|---|
| 19-98984 | GA | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573430400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602115200000",
"number": "1003451394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 INTERNATIONAL PKWY STE 200",
"city": "LAKE MARY",
"state": "FL",
"postal_code": "327465028",
"telephone_number": "706-980-4700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "535 RIVERSTONE PKWY STE 100",
"city": "CANTON",
"state": "GA",
"postal_code": "301145328",
"telephone_number": "470-531-0430",
"fax_number": "470-408-2550"
}
],
"practiceLocations": [
{
"address_1": "2121 Highway 140 NW",
"address_purpose": "LOCATION",
"city": "Adairsville",
"state": "GA",
"postal_code": "301034809",
"country_code": "US",
"telephone_number": "706-980-4700",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WHITE",
"first_name": "CASAUNDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-11",
"last_updated": "2020-10-08",
"certification_date": "2020-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "19-98984",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Canton, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.