Holly Joy Dibert I, ATC

Primary specialty

Surgical TechnologistTaxonomy code 246ZS0410X

License

10-0825 Issued in GA

Practice address

1014 Sycamore Dr Ste B
Decatur, GA 30030-1644

Phone

(404) 299-1700

Fax

(404) 299-1616

NPI assigned

Jun 22, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320019200000",
    "number": "1366648719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2610 AVERY PARK CIR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303602576",
            "telephone_number": "404-285-5560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1014 SYCAMORE DR STE B",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301644",
            "telephone_number": "404-299-1700",
            "fax_number": "404-299-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBERT",
        "first_name": "HOLLY",
        "middle_name": "JOY",
        "name_prefix": "Ms.",
        "name_suffix": "I",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2011-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IA",
            "license": "00300",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MN",
            "license": "1835",
            "primary": false
        },
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "GA",
            "license": "10-0825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. BENDIKS",
            "identifier": "1518959006",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kari L. Dianich, D.C.
• Gil A Diaz Vega, M.D.
• Alyse Diaz, RCS
• Nicole R Diaz, CTRS
• Sheena Diaz, LPC
• Christy L Dickerson, NP-C
• Savannah Diggs, LPC
• Gia M Digiacomo
• Dignity Counseling LLC
• Justine Dillard

• Surgical Technologist in Decatur, GA
• Providers in Decatur, GA by specialty
• Surgical Technologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2011; 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.