Georgi Stamatov Dimov, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH14415 Issued in FL

Practice address

5400 S Williamson Blvd Apt 2-201
Port Orange, FL 32128-6531

Phone

(571) 426-6061

NPI assigned

Feb 15, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• GD Chiropractic and Massage LLC

  • Clinic/Center
  • Port Orange, FL
  • NPI 1437938776
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1676419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695513600000",
    "number": "1326746777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 S WILLIAMSON BLVD APT 1-214",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321286502",
            "telephone_number": "571-426-6061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 S WILLIAMSON BLVD APT 2-201",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321286531",
            "telephone_number": "571-426-6061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMOV",
        "first_name": "GEORGI",
        "middle_name": "STAMATOV",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-15",
        "last_updated": "2023-09-24",
        "certification_date": "2023-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA93347",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH14415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Morgan Dietch III, M.D.
• Kaitlyn Dietrich
• Tina Marie Digiovanni, DC
• Brianna Dillard
• Haleigh Elisabeth Dillender, BCBA
• Discovery Association, LLC
• Matthew W Ditslear, LMFT
• John Dixon
• DLP Imaging Inc
• Jessica Doll

• Chiropractor in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2023; 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.