Active NPI
James Michael Ditolla, D.O.
- Anesthesiology Physician
- Kennesaw, GA
National Provider Identifier
1437579042
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 46394
- Practice address
- 1275 Shiloh Rd NW Ste 2120
Kennesaw, GA 30144-7199 - Phone
- (631) 671-1194
- NPI assigned
- Apr 22, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 46394 | GA | Primary |
Addresses
Primary practice location
1275 Shiloh Rd NW Ste 2120
Kennesaw, GA 30144-7199
Mailing address
1902 Grenache LN NW
Kennesaw, GA 30152-6771
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46394 | GA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684195200000",
"number": "1437579042",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1902 GRENACHE LN NW",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301526771"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1275 SHILOH RD NW STE 2120",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301447199",
"telephone_number": "631-671-1194"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DITOLLA",
"first_name": "JAMES",
"middle_name": "MICHAEL",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-04-22",
"last_updated": "2023-05-16",
"certification_date": "2023-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "GA",
"license": "46394",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennesaw, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.