Quenderrion Marquez White

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

124 S Main St
Jonesboro, GA 30236-3599

Phone

(404) 695-2195

NPI assigned

Jan 17, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547769600000",
    "number": "1144794710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1243",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302330026",
            "telephone_number": "404-695-2195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 S MAIN ST",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302363599",
            "telephone_number": "404-695-2195"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "133 Hickory St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "GA",
            "postal_code": "302331730",
            "country_code": "US",
            "telephone_number": "404-695-2195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "QUENDERRION",
        "middle_name": "MARQUEZ",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-17",
        "last_updated": "2019-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Manager/Care Coordinator in Jonesboro, GA
• Providers in Jonesboro, GA by specialty
• Case Manager/Care Coordinator in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2019; 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.