Individual provider Active NPI

Jami Nicole Difabio, DPT

  • Physical Therapist
  • Gainesville, GA
National Provider Identifier
1548096647
Registry record updated Sep 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT021335 Issued in OH
Practice address
2480 Limestone Pkwy Ste 107
Gainesville, GA 30501-2088
Phone
(770) 967-4377
NPI assigned
Sep 13, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT021335 OH Primary

Addresses

Primary practice location

2480 Limestone Pkwy Ste 107
Gainesville, GA 30501-2088

Mailing address

6204 New Holland Way NE Unit 6204
Gainesville, GA 30501-0019

Other practice location 1

4754 Martin Rd # 200
Flowery Branch, GA 30542-3507
Phone (770) 967-4377

Other practice location 2

415 Horizon Dr Ste 250
Suwanee, GA 30024-4647
Phone (678) 505-1995

Other practice location 3

2300 Liam Ave
Dacula, GA 30019-2263
Phone (470) 294-0052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241204004300 GA Practitioner - Physical Therapist in Private Practice 9234665944 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Back in the Game Physical Therapy, Inc 17 clinicians

Practice addresses (Care Compare)

4754 Martin Rd
Suite 200
Flowery Branch, GA 30542-3507
Phone (770) 967-4377

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT021335OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Back in the Game Physical Therapy, Inc CurrentSince Oct 7, 2024 Accepting new patients
Northeast Georgia Rehabilitation Center,Inc PastSince Oct 7, 2024 Accepting new patients

Locations

2300 Liam Ave
Ste 104
Dacula, GA 30019
Phone (470) 294-0052

2300 Liam Ave
Dacula, GA 30019
Phone (470) 294-0052

4754 Martin Rd
#200
Flowery Branch, GA 30542
Phone (770) 967-4377

2480 Limestone Pkwy
Ste 107
Gainesville, GA 30501
Phone (770) 967-4377

2800 Horizon Ridge Ct
Ste 250
Suwanee, GA 30024
Phone (678) 505-1995

415 Horizon Dr
Ste 250
Suwanee, GA 30024
Phone (678) 505-1995

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1726185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726185600000",
    "number": "1548096647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6204 NEW HOLLAND WAY NE UNIT 6204",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305010019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 LIMESTONE PKWY STE 107",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012088",
            "telephone_number": "770-967-4377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4754 Martin Rd # 200",
            "address_purpose": "LOCATION",
            "city": "Flowery Branch",
            "state": "GA",
            "postal_code": "305423507",
            "country_code": "US",
            "telephone_number": "770-967-4377",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "415 Horizon Dr Ste 250",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300244647",
            "country_code": "US",
            "telephone_number": "678-505-1995",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2300 Liam Ave",
            "address_purpose": "LOCATION",
            "city": "Dacula",
            "state": "GA",
            "postal_code": "300192263",
            "country_code": "US",
            "telephone_number": "470-294-0052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIFABIO",
        "first_name": "JAMI",
        "middle_name": "NICOLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-13",
        "last_updated": "2024-09-13",
        "certification_date": "2024-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT021335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.