Individual provider Active NPI

Caric A White

  • Physical Therapist
  • College Park, GA
National Provider Identifier
1679749956
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT008297 Issued in GA
Practice address
5678 Greensage Dr
College Park, GA 30349-8739
Phone
(305) 778-3082
NPI assigned
May 6, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT008297 GA Primary

Addresses

Primary practice location

5678 Greensage Dr
College Park, GA 30349-8739

Mailing address

5678 Greensage Dr
College Park, GA 30349-8739
Phone (305) 778-3082

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250703002821 GA Practitioner - Physical Therapist in Private Practice 0749794543 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT008297GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pruitthealth Therapy Services, Inc. Physical Therapist CurrentSince Jul 1, 2025 Accepting new patients

Locations

1626 Jeurgens Ct
Norcross, GA 30093
Phone (770) 806-6875

1967 Highway 54 W
Peachtree City, GA 30269
Phone (678) 787-8646

Organizations & group practices 1

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": "1210032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210032000000",
    "number": "1679749956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5678 GREENSAGE DR",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303498739",
            "telephone_number": "305-778-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5678 GREENSAGE DR",
            "city": "COLLEGE PARK",
            "state": "GA",
            "postal_code": "303498739",
            "telephone_number": "305-778-3082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "CARIC",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-06",
        "last_updated": "2008-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Park, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.