Active NPI
Gregory Lawrence White, P.T.
- Physical Therapist
- Syracuse, NY
National Provider Identifier
1063616258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 012647-1
- Practice address
- 170 Intrepid LN
Syracuse, NY 13205-2545 - Phone
- (315) 469-0383
- NPI assigned
- Jun 12, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 012647-1 | NY | Primary |
Addresses
Primary practice location
170 Intrepid LN
Syracuse, NY 13205-2545
Mailing address
4090 Mercun Dr
Jamesville, NY 13078-8757
Phone (315) 492-4851
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
| License | State | Type | Specialty |
|---|---|---|---|
| 012647-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184889600000",
"number": "1063616258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4090 MERCUN DR",
"city": "JAMESVILLE",
"state": "NY",
"postal_code": "130788757",
"telephone_number": "315-492-4851"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 INTREPID LN",
"city": "SYRACUSE",
"state": "NY",
"postal_code": "132052545",
"telephone_number": "315-469-0383"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "GREGORY",
"middle_name": "LAWRENCE",
"name_prefix": "Mr.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-12",
"last_updated": "2007-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "012647-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Syracuse, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.