Active NPI
Colton Randolph White
- Pharmacist
- Evans, GA
National Provider Identifier
1720702632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RPH033988
- Practice address
- 4310 Washington Rd
Evans, GA 30809-3957 - Phone
- (770) 860-4179
- NPI assigned
- Oct 4, 2022
- Last updated
- Oct 4, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RPH033988 | GA | Primary |
Addresses
Primary practice location
4310 Washington Rd
Evans, GA 30809-3957
Mailing address
4310 Washington Rd
Evans, GA 30809-3957
Phone (770) 860-4179
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH033988 | GA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
4310 Washington Rd
Evans, GA 30809
Phone (706) 860-4179
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664841600000",
"number": "1720702632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4310 WASHINGTON RD",
"city": "EVANS",
"state": "GA",
"postal_code": "308093957",
"telephone_number": "770-860-4179"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4310 WASHINGTON RD",
"city": "EVANS",
"state": "GA",
"postal_code": "308093957",
"telephone_number": "770-860-4179"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "COLTON",
"middle_name": "RANDOLPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-10-04",
"last_updated": "2022-10-04",
"certification_date": "2022-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "GA",
"license": "RPH033988",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evans, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.