Carolyn Gayle Dibella, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2306601947 Issued in VA

Practice address

2579 John Milton Dr
Suite 120
Herndon, VA 20171-2563

Phone

(703) 860-2346

Fax

(703) 860-2348

NPI assigned

May 21, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Strait Physical Therapy, LLC

  • Physical Therapist
  • Herndon, VA
  • NPI 1154448553

  Physical Therapy Assistant

  NPD (past)

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346458494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4128 DOVEVILLE LN",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220321446",
            "telephone_number": "571-235-1613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2579 JOHN MILTON DR",
            "address_2": "SUITE 120",
            "city": "HERNDON",
            "state": "VA",
            "postal_code": "201712563",
            "telephone_number": "703-860-2346",
            "fax_number": "703-860-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBELLA",
        "first_name": "CAROLYN",
        "middle_name": "GAYLE",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306601947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desi Farren C.a.C. & Associates
• Behailu Zeleke Desta, RPH
• Jessica W Dezzutti, M.ED
• Subarna B Dharia, MD
• Diabetic Supplies Mid-Atlantic
• Raven Elizabeth Dickerson, LCSW
• Kevin Diep, DPM
• Erin E Dillaman, DPT
• Sonia Dilolli, DDS
• Sam T Dinh

• Physical Therapy Assistant in Herndon, VA
• Providers in Herndon, VA by specialty
• Physical Therapy Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.