Active NPI
Melia Nicole Whitaker, PT, DPT
- Physical Therapist
- Loganville, GA
National Provider Identifier
1194374785
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1326817
- Practice address
- 3455 Highway 81 South
Loganville, GA 30052-3918 - Phone
- (678) 635-8280
- Fax
- (678) 635-8285
- NPI assigned
- Sep 6, 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1326817 | TX | Primary |
Addresses
Primary practice location
3455 Highway 81 South
Loganville, GA 30052-3918
Mailing address
6401 Eldorado Pkwy
Ste 337
McKinney, TX 75070-6520
Phone (817) 381-5177
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 |
|---|---|---|---|
| 1326817 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567728000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683763200000",
"number": "1194374785",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6401 ELDORADO PKWY",
"address_2": "STE 337",
"city": "MCKINNEY",
"state": "TX",
"postal_code": "750706520",
"telephone_number": "817-381-5177",
"fax_number": "817-383-0049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3455 HIGHWAY 81 SOUTH",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300523918",
"telephone_number": "678-635-8280",
"fax_number": "678-635-8285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITAKER",
"first_name": "MELIA",
"middle_name": "NICOLE",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-06",
"last_updated": "2023-05-11",
"certification_date": "2023-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1326817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loganville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.