Individual provider Active NPI

Anthony Dimola, DC

  • Chiropractor
  • Woodstock, GA
National Provider Identifier
1295780708
Registry record updated Dec 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5520 Issued in GA
Practice address
221 River Park North Dr
Woodstock, GA 30188-7835
Phone
(770) 924-1995
Fax
(770) 924-3930
NPI assigned
May 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5520 GA Primary

Addresses

Primary practice location

221 River Park North Dr
Woodstock, GA 30188-7835

Mailing address

4515 Dennington Trce
Cumming, GA 30040-8551

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110223000080 GA Practitioner - Chiropractic 9436330529 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

221 River Park N Dr
Woodstock, GA 30188-7835
Phone (770) 924-1995

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dimola Famiily Chiropractic Inc Chiropractor CurrentSince Feb 1, 1997 Accepting new patients

Locations

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

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293408000000",
    "number": "1295780708",
    "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"
        },
        {
            "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",
            "fax_number": "770-924-3930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMOLA",
        "first_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-23",
        "last_updated": "2010-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "5520",
            "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 Dec 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.