Bennie R. White Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

056245 Issued in GA

Practice address

794 McDonough Rd
Suite 105
Jackson, GA 30233-1572

Phone

(770) 775-2341

Fax

(770) 775-3668

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Meharry Medical College School of Medicine, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Hospital & facility affiliations

• Wellstar Sylvan Grove Medical Center Hospital, Jackson, GA, CCN 111319

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts, Doctor of Medicine

Practice roles

Locations

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.

• Bennie R White Jr MD Inc

  • Primary Care Clinic/Center
  • Jackson, GA
  • NPI 1306019104
  Medicare reassignment NPD Authorized official
• Huntington Hospital Dolan Family Health Center

  • Health Service Clinic/Center
  • Greenlawn, NY
  • NPI 1578593588
  NPD (past)
• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572

  Family Medicine

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Wellstar Sylvan Grove Hospital, Inc

  • Critical Access Hospital
  • Jackson, GA
  • NPI 1619997079
  Care Compare affiliation

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355788800000",
    "number": "1376575225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "794 MCDONOUGH RD",
            "address_2": "SUITE 105",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302331572",
            "telephone_number": "770-775-2341",
            "fax_number": "770-775-3668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "794 MCDONOUGH RD",
            "address_2": "SUITE 105",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302331572",
            "telephone_number": "770-775-2341",
            "fax_number": "770-775-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "BENNIE",
        "middle_name": "R.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2012-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "056245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "345029068A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gareth Gene Walker
• Jacinta Webb
• Wellstar Sylvan Grove Hospital, Inc
• Wellstar Sylvan Grove Hospital, Inc
• Westbury Medical Care Home, Inc.
• Marie L White, PA-C
• Hannah Whitfield, SPEECH LANGUAGE PATH
• Krystle Jo Whitten, RN
• Latora Williams, MD
• Lindsey Wold, LPC

• Family Medicine Physician in Jackson, GA
• Providers in Jackson, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.