Individual provider Active NPI

Anthony Ricardo White, D.C.

  • Chiropractor
  • Kennesaw, GA
National Provider Identifier
1003937400
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR007626 Issued in GA
Practice address
1815 Old 41 Hwy NW Ste 370
Kennesaw, GA 30152-4429
Phone
(770) 575-3103
NPI assigned
Apr 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHIR007626 GA Primary

Addresses

Primary practice location

1815 Old 41 Hwy NW Ste 370
Kennesaw, GA 30152-4429

Mailing address

1815 Old 41 Hwy NW Ste 370
Kennesaw, GA 30152-4429
Phone (770) 575-3103

Other practice location 1

55 E Paulding Dr
Suite 146
Dallas, GA 30157-7191
Phone (678) 383-8188

Other practice location 2

5041 Dallas Hwy Ste 500
Powder Springs, GA 30127-6458
Phone (770) 919-7171

Other identifiers 2

IdentifierTypeStateIssuer
9344506OtherGAPHCS
665387OtherGAUNITED HEALTHCARE

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
CHIR007626GAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Paulding County Chiropractic Chiropractor Current Accepting new patients
West Cobb Chiropractic Chiropractor Past Accepting new patients

Locations

55 E Paulding Dr
Ste 146
Dallas, GA 30157
Phone (678) 383-8188

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1003937400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 OLD 41 HWY NW STE 370",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524429",
            "telephone_number": "770-575-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 OLD 41 HWY NW STE 370",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301524429",
            "telephone_number": "770-575-3103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 E Paulding Dr",
            "address_2": "Suite 146",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "GA",
            "postal_code": "301577191",
            "country_code": "US",
            "telephone_number": "678-383-8188",
            "fax_number": "678-383-8035",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5041 Dallas Hwy Ste 500",
            "address_purpose": "LOCATION",
            "city": "Powder Springs",
            "state": "GA",
            "postal_code": "301276458",
            "country_code": "US",
            "telephone_number": "770-919-7171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "ANTHONY",
        "middle_name": "RICARDO",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2022-07-21",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR007626",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS",
            "identifier": "9344506",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "665387",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.