Kelvin D. White, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

33753 Issued in GA

Practice address

101 Devant St
Suite 902
Fayetteville, GA 30214-2710

Phone

(770) 716-8228

Fax

(770) 716-6588

NPI assigned

Dec 7, 2005

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: atlantasouthmedicalsolutions.kelvindwhite@159586.advancedmd-direct.com

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.

• North Fayette Family Practice

  • Ph.D. Medical Genetics
  • Fayetteville, GA
  • NPI 1154431732
  NPD (past) Authorized official
• Comfort Medical Center Phoenix Blvd, LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1003512500
  NPD
• Living Well Primary Care, LLC

  • Family Medicine Physician
  • Fayetteville, GA
  • NPI 1144593021
  NPD (past)
• Concentra Primary Care PA

  dba Concentra Primary Care

  • Primary Care Clinic/Center
  • Addison, TX
  • NPI 1154602845
  NPD (past)

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342396800000",
    "number": "1457336935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DEVANT ST",
            "address_2": "SUITE 902",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142710",
            "telephone_number": "770-716-8228",
            "fax_number": "770-716-6588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DEVANT ST",
            "address_2": "SUITE 902",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142710",
            "telephone_number": "770-716-8228",
            "fax_number": "770-716-6588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KELVIN",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-07",
        "last_updated": "2012-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "33753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000445156F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Janae Crashone Whatley-Flecha, MS, BCBA
• Tameika Denise Wheeler-Hall, D.M.D.
• Lara Book Whitaker, P.T.
• Julian Christopher White, DDS
• Keisha L White, ED.S, NCC,LAPC
• Nikel White, MS OTR/L
• Niya White, LCSW
• Robin Lowman White
• Sandra White
• Sarah G. E. White, D.O.

• Family Medicine Physician in Fayetteville, GA
• Providers in Fayetteville, 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 Jul 16, 2012; 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.