Individual provider Active NPI

Victoria Yalonda Warner-White, M.D.

  • Pediatrics Physician
  • Saint Marys, GA
National Provider Identifier
1386798312
Registry record updated Nov 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
039504 Issued in GA
Practice address
2040 Dan Proctor Dr
Suite #230
Saint Marys, GA 31558-3811
Phone
(912) 576-6464
Fax
(912) 576-6460
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 039504 GA Primary

Addresses

Primary practice location

2040 Dan Proctor Dr
Suite #230
Saint Marys, GA 31558-3811

Mailing address

2040 Dan Proctor Dr
Suite #230
Saint Marys, GA 31558-3811
Phone (912) 576-6464

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150629000457 GA Practitioner - Pediatric Medicine 2769794114 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
039504GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Florida Jacksonville Physicians, Inc. CurrentSince Jul 6, 2015 Accepting new patients
University of Florida Jacksonville Physicians, Inc. Pediatrics CurrentSince Jul 6, 2015 Accepting new patients
Southeast Georgia Health System, Inc. Past Accepting new patients

Locations

201 Lakeshore Pt
Ste B
Saint Marys, GA 31558
Phone (912) 729-6821

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/6996dfed-5d48-4d59-8b7b-8bd86c9887c0/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289260800000",
    "number": "1386798312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 DAN PROCTOR DR",
            "address_2": "SUITE #230",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583811",
            "telephone_number": "912-576-6464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 DAN PROCTOR DR",
            "address_2": "SUITE #230",
            "city": "SAINT MARYS",
            "state": "GA",
            "postal_code": "315583811",
            "telephone_number": "912-576-6464",
            "fax_number": "912-576-6460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WARNER-WHITE",
        "first_name": "VICTORIA",
        "middle_name": "YALONDA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2010-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "039504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Marys, GA

Sources for this page

Verify at the official NPI Registry.