Kelly Brogdon White, MS, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT003451 Issued in GA

Practice address

3005 Old Alabama Rd BLDG E
Johns Creek, GA 30022-8594

Phone

(770) 552-8852

Fax

(770) 552-8481

NPI assigned

Jun 9, 2025

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

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Tufts University School of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Body-N-BalanceGroup PAC ID 6709131519, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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.

• Body-N-Balance

  • Physical Therapist
  • Johns Creek, GA
  • NPI 1295157931
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1639064025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10315 AUTRY PL",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300225301",
            "telephone_number": "404-993-5513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 OLD ALABAMA RD BLDG E",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300228594",
            "telephone_number": "770-552-8852",
            "fax_number": "770-552-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KELLY",
        "middle_name": "BROGDON",
        "name_prefix": "Mrs.",
        "credential": "MS, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT003451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daneka Y West
• Grayson Leigh West, LPC
• Shanquan West
• Nikeisha Whatley
• Caroleshia White-Tower
• Kimberly Nicole White
• Mosesal Zakia White
• Shalonda White, PHARMD
• Robin Jones Whitesides, RPH
• Jeremy Whitley, M.D.

• Occupational Therapist in Johns Creek, GA
• Providers in Johns Creek, GA by specialty
• Occupational Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.