Individual provider Active NPI

Jacquelyn Lachelegilchrist White, DPT

  • Physical Therapist
  • Suwanee, GA
National Provider Identifier
1255707865
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT012021 Issued in GA
Practice address
2780 W Village Dr Ste G
Suwanee, GA 30024-5536
Phone
(470) 533-4610
NPI assigned
Aug 18, 2015
Last updated
Jun 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 048656 NY
Physical Therapist 225100000X PT012021 GA Primary

Addresses

Primary practice location

2780 W Village Dr Ste G
Suwanee, GA 30024-5536

Mailing address

2001 Butterfield Rd Ste 1600
Downers Grove, IL 60515-1211
Phone (866) 370-8206

Other practice location 1

68 Breezy Valley Connector
Hiram, GA 30141-3054
Phone (724) 816-1800

Other practice location 2

383 White Spruce Blvd
Rochester, NY 14623-1603
Phone (585) 442-6067

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250722000211 NY Practitioner - Physical Therapist in Private Practice 3870848427 Reassigns benefits to 1 organization
I20251204004785 DC Practitioner - Physical Therapist in Private Practice 3870848427 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

138 5TH Ave
FL 2
New York, NY 10011-4300

138 5TH Ave
FL 2
New York, NY 10011-4367

138 5TH Ave FL
Suite 2
New York, NY 10011-4367

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT012021GAMDPhysical Therapist
048656NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Shuman Physical Therapy Associates, P.C. Physical Therapist CurrentSince Jun 30, 2026 Accepting new patients
Physical Therapy Services of Flatiron PC Physical Therapist CurrentSince Jun 18, 2025 Accepting new patients
Expressable Speech-Language Pathology, P.C. Physical Therapist Past Accepting new patients
MCM Rehabilitation LLC PastSince Oct 5, 2025 Accepting new patients

Locations

1500 K St NW
Fl 2
Washington, DC 20005
Phone (212) 287-4257

2 Bethesda Metro Ctr
Fl 1
Bethesda, MD 20814
Phone (212) 287-4257

138 5th Ave
Fl 2
New York, NY 10011
Phone (212) 287-4257

383 White Spruce Blvd
Rochester, NY 14623
Phone (585) 442-6067

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782777600000",
    "number": "1255707865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BUTTERFIELD RD STE 1600",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151211",
            "telephone_number": "866-370-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 W VILLAGE DR STE G",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300245536",
            "telephone_number": "470-533-4610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "68 Breezy Valley Connector",
            "address_purpose": "LOCATION",
            "city": "Hiram",
            "state": "GA",
            "postal_code": "301413054",
            "country_code": "US",
            "telephone_number": "724-816-1800",
            "fax_number": "865-951-7273",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "383 White Spruce Blvd",
            "address_purpose": "LOCATION",
            "city": "Rochester",
            "state": "NY",
            "postal_code": "146231603",
            "country_code": "US",
            "telephone_number": "585-442-6067",
            "fax_number": "585-442-6073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITE",
        "first_name": "JACQUELYN",
        "middle_name": "LACHELEGILCHRIST",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-18",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "048656",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.