Individual provider Active NPI

Dara Danelle Toole, PA-C

  • Physician Assistant
  • Savannah, GA
National Provider Identifier
1497193742
Registry record updated Aug 7, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
006836 Issued in GA
Practice address
210 E Derenne Ave
Savannah, GA 31405
Phone
(912) 644-5300
Fax
(912) 644-5241
NPI assigned
Jun 10, 2013
Last updated
Aug 7, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 006836 GA Primary
Medical Physician Assistant 363AM0700X
Medical Physician Assistant 363AM0700X 006836 GA
Surgical Physician Assistant 363AS0400X 006836 GA

Addresses

Primary practice location

210 E Derenne Ave
Savannah, GA 31405

Mailing address

210 E Derenne Ave
Savannah, GA 31405-6736
Phone (912) 644-5300

Other practice location 1

1462 Montreal Rd
Suite 101
Tucker, GA 30084-6929
Phone (770) 363-8770 ext. 104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181115002059 GA Practitioner - Physician Assistant 7517211204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2505 Newpoint Pkwy
Suite 100
Lawrenceville, GA 30043-6003
Phone (678) 257-7078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
006836GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sfe Advanced Medical Consulting CurrentSince Jun 25, 2023 Accepting new patients
Optim Orthopedics, LLC Past Accepting new patients
Optim Orthopedics, LLC PastSince Oct 6, 2019 Accepting new patients

Locations

2505 Newpoint Pkwy
Ste 100
Lawrenceville, GA 30043
Phone (678) 257-7078

1462 Montreal Rd
Ste 101
Tucker, GA 30084
Phone (678) 257-7078

Interoperability endpoints

  • Direct secure messaging: dara.toole.1@17193.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/17193/brand/1/csg/1/fhir/r4

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1497193742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E DERENNE AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314056736",
            "telephone_number": "912-644-5300",
            "fax_number": "912-644-5241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E DERENNE AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31405",
            "telephone_number": "912-644-5300",
            "fax_number": "912-644-5241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1462 Montreal Rd",
            "address_2": "Suite 101",
            "address_purpose": "LOCATION",
            "city": "Tucker",
            "state": "GA",
            "postal_code": "300846929",
            "country_code": "US",
            "telephone_number": "770-363-8770 x104",
            "fax_number": "770-436-8042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TOOLE",
        "first_name": "DARA",
        "middle_name": "DANELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-10",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "006836",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "006836",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "GA",
            "license": "006836",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.