Beth Dziczkowski, NURSE PRACTITIONER

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

RN264561 Issued in GA

Practice address

406 Kings Point Dr
Canton, GA 30115-5210

Phone

(404) 966-9296

NPI assigned

Jun 12, 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

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

Specialty

Nurse Practitioner

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

North Atlanta Professional Services LLCGroup PAC ID 0840291944, 423 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Cherokee Hospital, Canton, GA, CCN 110008

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

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.

• North Atlanta Professional Services LLC

  • Psychologist
  • Atlanta, GA
  • NPI 1316959869
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  dba Northside Hospital Cherokee

  • General Acute Care Hospital
  • Canton, GA
  • NPI 1225050396
  Care Compare affiliation

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

{
    "created_epoch": "1749686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749686400000",
    "number": "1134014657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 KINGS POINT DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301155210",
            "telephone_number": "404-966-9296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 KINGS POINT DR",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301155210",
            "telephone_number": "404-966-9296"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZICZKOWSKI",
        "first_name": "BETH",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-12",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "GA",
            "license": "RN264561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DV Pediatrics LLC
• Dwayne a Lay LLC (Elite Foot and Ankle)
• Edward Dyckman, MD
• Anna O Dyer
• Dynamic Hospice of North Georgia, Inc.
• Lilia Dzyuba, RN
• Ear Nose Throat & Specialist-Cherokee Sinus Center
• William L. Early, M.D.
• William Paul Early, D.C.
• Bradley Earnest, PT

• Acute Care Nurse Practitioner in Canton, GA
• Providers in Canton, GA by specialty
• Acute Care Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; 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.
• 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.