Organization Active NPI

Dimola Famiily Chiropractic Inc

  • Chiropractor
  • Woodstock, GA
National Provider Identifier
1164633863
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR005520 Issued in GA
Legal business name
DIMOLA FAMIILY CHIROPRACTIC INC
Practice address
221 River Park North Dr
Woodstock, GA 30188-7835
Phone
(770) 924-1995
NPI assigned
May 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Authorized official

Name
Dr. Anthony DimolaNPI 1295780708
Title
Chiropractor
Phone
(770) 924-1995

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CHIR005520 GA Primary

Addresses

Primary practice location

221 River Park North Dr
Woodstock, GA 30188-7835

Mailing address

4515 Dennington Trce
Cumming, GA 30040-8551
Phone (770) 889-8941

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110223000013 GA Part B Supplier - Clinic/Group Practice 7618158700 Receives reassigned benefits from 1 practitioner
Practice locations: Woodstock, GA

National Provider Directory

National Provider Directory

Locations

221 River Park North Dr
Woodstock, GA 30188
Phone (770) 924-1995

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1164633863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 DENNINGTON TRCE",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300408551",
            "telephone_number": "770-889-8941",
            "fax_number": "770-924-3930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 RIVER PARK NORTH DR",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301887835",
            "telephone_number": "770-924-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIMOLA FAMIILY CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "DIMOLA",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "770-924-1995",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR005520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.