Marie L White, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

005122 Issued in GA

Practice address

1502 W 3Rd St
Jackson, GA 30233-1979

Phone

(678) 774-0430

Fax

(770) 775-3410

NPI assigned

Oct 9, 2008

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Magnolia Medical Clinic, P.C.

  • Internal Medicine Physician
  • Norcross, GA
  • NPI 1184711517
  Medicare reassignment
• Aylo Health, LLC

  • Family Medicine Physician
  • Atlanta, GA
  • NPI 1013018811
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Ellenwood, GA
  • NPI 1447290218
  NPD (past)
• Aylo Health, LLC

  • Family Medicine Physician
  • Locust Grove, GA
  • NPI 1710929914
  NPD (past)
• Aylo Health, LLC

  • Sleep Medicine (Family Medicine) Physician
  • Stockbridge, GA
  • NPI 1922831445
  NPD (past)

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

{
    "created_epoch": "1223510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233619200000",
    "number": "1710138680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 W 3RD ST",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302331979",
            "telephone_number": "678-774-0430",
            "fax_number": "770-775-3410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 W 3RD ST",
            "city": "JACKSON",
            "state": "GA",
            "postal_code": "302331979",
            "telephone_number": "678-774-0430",
            "fax_number": "770-775-3410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "MARIE",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-09",
        "last_updated": "2009-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "005122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacinta Webb
• Wellstar Sylvan Grove Hospital, Inc (Sylvan Grove Hospital)
• Wellstar Sylvan Grove Hospital, Inc (WellStar Sylvan Grove Hospital)
• Westbury Medical Care Home, Inc.
• Bennie R. White Jr., MD
• Hannah Whitfield, SPEECH LANGUAGE PATH
• Krystle Jo Whitten, RN
• Latora Williams, MD
• Lindsey Wold, LPC
• Marcia Younker, APRN

• Physician Assistant in Jackson, GA
• Providers in Jackson, GA by specialty
• Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.