Victoria Suttles White, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

7961 Issued in GA

Practice address

312 Westside Dr
Douglas, GA 31533-3530

Phone

(912) 384-2200

NPI assigned

May 9, 2016

Last updated

Aug 9, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ear, Nose, Throat and Allergy Associates of South Georgia PCGroup PAC ID 0941291520, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• SGMC Health Hospital, Valdosta, GA, CCN 110122

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Ear, Nose, Throat, and Allergy Associates of South Georgia PC

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Valdosta, GA
  • NPI 1629086327
  Medicare reassignment Care Compare group
• Westside Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Douglas, GA
  • NPI 1013158948
  NPD (past)

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

• South Georgia Medical Center Inc

  dba SGMC Health

  • General Acute Care Hospital
  • Valdosta, GA
  • NPI 1144096553
  Care Compare affiliation

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

{
    "created_epoch": "1462752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565308800000",
    "number": "1578919643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 WESTSIDE DR",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315333530",
            "telephone_number": "912-384-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 WESTSIDE DR",
            "city": "DOUGLAS",
            "state": "GA",
            "postal_code": "315333530",
            "telephone_number": "912-384-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "VICTORIA",
        "middle_name": "SUTTLES",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-09",
        "last_updated": "2019-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "7961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Westside Drugs Inc (Hospital Discount Drugs)
• Westside Drugs, Inc (South Georgia Home Healthcare)
• Westside Surgery Center, LLC
• Westside Surgery LLC
• Heidi Knight White, DMD
• Bonnie Dee Whitfield, MSRDLD
• Amy Michelle Whitley
• Rachel V Whitley, CSFA, CST
• James Steve Wilkerson, DMD
• Joel A. Wilkes

• Medical Physician Assistant in Douglas, GA
• Providers in Douglas, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; 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.