Robert G Whitener, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

002074 Issued in GA

Practice address

2878 Five Forks Trickum Rd
Suite 2a
Lawrenceville, GA 30044-5896

Phone

(678) 344-8700

Fax

(678) 344-8600

NPI assigned

Sep 15, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351814400000",
    "number": "1629174123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 CHELSEA CT",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301898173",
            "telephone_number": "678-344-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2878 FIVE FORKS TRICKUM RD",
            "address_2": "SUITE 2A",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300445896",
            "telephone_number": "678-344-8700",
            "fax_number": "678-344-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITENER",
        "first_name": "ROBERT",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2012-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "002074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "002074",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Memee White
• Terri L White, LPC
• Thomas White
• Yolanda E. White, LISW-CP
• Thomas M. Whiteneck, D.O.
• Kayce Whitley, M.S.,CCC-SLP
• Eric Lee Whitton Jr., MD
• Leigh Evans Whitton, D.P.T.
• Whole Life Health Center LLC (Pain Center of Gwinnett)
• Wholehearted Healing Counseling LLC

• Medical Physician Assistant in Lawrenceville, GA
• Providers in Lawrenceville, 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 Nov 2, 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.