PROF. MIRANDA WHITE (DPT) – Physical Therapist, NPI 1386744233

PROF. MIRANDA WHITE (DPT) is a healthcare provider. based in Mableton, Georgia. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. PT004564 (GA). The NPI Number for PROF. MIRANDA WHITE (DPT) is 1386744233

Main info

Female
Sole Proprietor
12 Years Of Experience
Accepts Medicare Assignment
Name
PROF. MIRANDA WHITE (DPT)
NPI
1386744233
Phone
(678) 685-1386
Address
1228 WANDERING VINE CT. SE
Enumeration Date
22 September 2006
Last Update Date
30 January 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4789564916
Graduation Year
2014 (12 years ago)
PAC ID
0648278655
Group Practice PAC ID
5395971402
Professional Enrollment ID
I20220427001908
Address ID
GA310086271BY100XXDRXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience76
Completeness75
Years active:19State licenses:2Digital endpointsOther names

2,871 PHYSICAL THERAPIST IN PRIVATE PRACTICE in GA

Provider Addresses for PROF. MIRANDA WHITE (DPT)

  • 1228 WANDERING VINE CT. SE

    MABLETON, GA 30126

    Phone: (678) 685-1386

    Fax: (678) 601-1341

    Type: Mailing

  • 1311A FULTON INDUSTRIAL BLVD NW STE 5

    ATLANTA, GA 303361533

    Phone: (678) 685-1386

    Fax: (678) 601-1341

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-04-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220427001908IPhysical Therapist In Private PracticeGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30126)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5395971402View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeGA
-GA

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Frequently asked questions

Does PROF. MIRANDA WHITE (DPT) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — PROF. MIRANDA WHITE (DPT) uses 1386744233.
Is PROF. MIRANDA WHITE (DPT) still practicing?
PROF. MIRANDA WHITE (DPT) is currently listed as active in the public NPI registry.
What taxonomy line describes PROF. MIRANDA WHITE (DPT)?
For research purposes, treat PROF. MIRANDA WHITE (DPT) as Physical Therapist in this dataset. Clinical services aligned with this taxonomy classification.
Where is PROF. MIRANDA WHITE (DPT) based?
PROF. MIRANDA WHITE (DPT) is tied to Mableton, Georgia in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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