Dillard Academy

Primary specialty

Local Education Agency (LEA)Taxonomy code 251300000X

License

8600110 Issued in NC

Legal business name

DILLARD ACADEMY

Doing business as

Dillard charter Academy

Practice address

8014 Cumming Hwy
Suite 403302
Canton, GA 30115-9339

Phone

(404) 806-0434

NPI assigned

Dec 19, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Jeff Baker, SC.D

Title

Advisor

Phone

(404) 806-0434

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Dillard charter Academy Doing business as

Tax ID family

Dillard Academy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Dillard Academy

  • Local Education Agency (LEA)
  • Canton, GA
  • NPI 1124459912
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeffrey L Baker, PH.D, MAC,HS-BCP

  • Professional Counselor
  • Canton, GA
  • NPI 1699913020
  NPD (past)

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

{
    "created_epoch": "1387411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387411200000",
    "number": "1356762207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 STEPHENS ST",
            "city": "GOLDSBORO",
            "state": "NC",
            "postal_code": "275306720",
            "telephone_number": "919-581-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8014 CUMMING HWY",
            "address_2": "SUITE 403302",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301159339",
            "telephone_number": "404-806-0434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DILLARD ACADEMY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-19",
        "last_updated": "2013-12-19",
        "status": "A",
        "authorized_official_last_name": "BAKER",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "ADVISOR",
        "authorized_official_telephone_number": "404-806-0434",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "SC.D"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "NC",
            "license": "96C",
            "primary": false
        },
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": "NC",
            "license": "8600110",
            "primary": true
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NC",
            "license": "8600110",
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": "NC",
            "license": "8600110",
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NC",
            "license": "8600110",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8600110",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dillard charter Academy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julia Ann Dibiccari
• Vincent Daniel Dicarlo, MD
• Douglas Dickey
• Digestive Healthcare of Ga, P.C. (Digestive Healthcare of GA Canton)
• Dillard Academy
• Allison Dillon
• Patrice James Dilwood, PHARMD
• Dima Healthcare, Inc (Northcrest Urgent Care & Family Practice)
• Nicholas Thomas Dimos
• Dirk Russell D.M.D., P.C.

• Local Education Agency (LEA) in Canton, GA
• Providers in Canton, GA by specialty
• Local Education Agency (LEA) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2013; 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.